National Institute of Electronics and Information Technology
                                           Calicut
 
Common Application Form for M.Tech in Embedded Systems (ES) & Electronics Design Technology (EDT) – 2017
Personal Information
Name in full in Capital (as in Degree certificate)*    
Expansion of initials
Age*      
Date of Birth* (dd/mm/yyyy) 
Address for Communication*    
Pin Code*    
Contact Details
Land Phone :
Mobile Phone
Email*      
Religion*    
Caste*    
Category
Sponsored
Physically Handicapped
Nativity  
Place of Birth*    
District*    
State of Domicile*    
Nationality*    
Mother Tongue*    
Father's Name *    
Mother's Name *    
Occupation of parent or guardian*    
Name & Relationship with Guardian *    
Annual Family Income*      
   
Educational Qualifications
Name of Degree  
Branch*    
Mode of Degree
Duration (in years)*    
Result Awaiting
Number of Back Papers
Name and address of the institution for B.Tech/B.E/AMIE*     
Name and address of the University for BTech/BE/AMIE*    
Name of Exam
10th/SSLC Plus Two BE / B.Tech/ AMIE
Aggregate Marks Obtained *
   
Max Marks *
   
Percentage of Marks *
   
Class/ Distinction *
   
Year of Passing *
   
   
GATE Details
Year of Passing
Score
Rank
Mark
Reg No
Paper
M Tech Preference - First
M Tech Preference -Second
Additional Qualifications
Professional Experience after Graduation if any
Employed
Registration Fee - (Rs 1000 for General, Rs 500 for SC/ST)                        Mode of Payments
Amount
Payment Details (Please specify the mode of payment, DDNo/Transaction No etc)
Payment Date (dd/mm/yyyy)