For Office use Only Admission against CAP / Institute Quota / Vacancy against CAP.

Registration No. _____Date_____

Phone: Office (02162)230636, 235290| Fax: 02162-235767 Email: str_kbpsatar@sancharnet.in

APPLICATION FORM FOR THE ADMISSION TO POST GRADUATE COURSE Academic Year 2013 2014
Name of course: M. E. Mechanical (Production Engg.) / Electronics Engg. 1. Name in Full (Block Letters) ___________ _____________________________________ ______ Surname First Middle

Photo

2. Address For Correspondence: ___________________________________ _____ __________________________ ___________________________________________

3. Date of Birth: ____________ __________ 4. Phone :________________ Mobile _____________E-Mail:__________________________ 5. Sex: Male/Female Status: Married / Unmarried 6. Whether belong to Backward Category: Yes/No If Yes Specify________ (SC / ST VJ/ DT/ NT1/NT2/NT 3/OBC/SBC etc.) 7. Are you physically handicapped? Yes/No 8. Is your Father Ex or Active defense serviceman? Yes/No 9. Are you a sponsored candidate? Yes/No If Yes Name of the Company/ Institute _______________________________ _____ Designation:_________________________ Working Period______________ _____

10. Academic Qualification: Year SSC HSC DIPLOMA F.E. S.E. T.E. B.E. University/Board Year of Passing No. of attempts % marks

11. Have you Qualified GATE? Yes/No A) If Yes GATE SCORE:_________ Year of Qualifying:________ GATE Rank:__________ B) CET SCORE :________

MERIT NO. :_________

12. DD of any nationalized bank of Rs. 1000/- is attached herewith (In favor of Principal, KBP college of Engineering and Polytechnic, Satara, Payable at Satara) DD No. ___________ Drawn on Bank:_____________________ Amount Rs.______________ (Note: Admission Processing Fee is non refundable.) 13. Following documents (Attested photocopies) are attached with the application form: B.E. Marks sheet. GATE Score Card / CET Score Card Sponsorship Letter (For sponsored Candidates only) Transfer or Leaving Certificate Migration Certificate (For other than Shivaji University Candidates) Nationality and domicile Certificate Caste Certificate Caste validity Certificate Non-Creamy layer Certificate for (VJ/ DT/ NT1/NT2/NT3/OBC/SBC)

I declare that the information above is true to the best of my knowledge I accept and agree to abide by the rules and regulations issued by institute, university, DTE and AICTE, Shikshan Shulka Samiti, now or in future and authorize the Principal to initiate suitable action in case of infringe the rules and regulations.

Date: Place Signature of Student

Note 1: Original Documents along with four attested photocopies of each are to be submitted at the time of final admission to the programme. Note 2: Students are required to submit undertaking in the enclosed format. Note 3: Admissions will be done on merit basis and as per DTE norms.

UNDERTAKING
All the candidates seeking admission to post graduate program in Engineering / Technology are required to give the following undertaking:In respect of admission process to PG program at KBP college of Engg. And Poly. Satara. I undertake as below: (a) I have read all the Rules of Admission for the current year and after understanding these rules, I have filled in this form of application for admission for the current year. (b) The information given by me in my application is true and correct to the best of my knowledge and belief. (c) I have not been debarred from appearing at any examination held by any Government constituted or Statutory Examination Authority in India. (d) I fully understand that the offer of a course or branch of engineering will be made to me depending on merit, inter-se and availability of a seat at the time of scrutiny of my application, when I report to the admission authority according to the schedule of admission. (e) I understand that no other document, other than those attached to the application form before the last date of admission will be entertained for the purpose of claims/concessions etc. in connection with my admission. (f) I understand that no refund of fees shall be made if I cancel the admission after commencement of the classes and if the seat due to cancellation is not filled. (g) I hereby agree to confirm to any rules, acts and laws enforced by Government including AntiRagging Act and I hereby undertake that so long as I am a student of the Institute, I will do nothing either inside or outside the Institute which may result in disciplinary action against me under the rules, acts and laws. (h) I fully understand that the Principal / Director of the Institute where I would be admitted will have full right to expel / rusticate me from the institute for any infringement of the Rules of conduct and discipline prescribed by the Institute / University. (i) I understand that the Post-Graduate program in Engineering / Technology being a full time 2 years program, I shall not pursue any other educational degree program / and not involve in any form of employment during the tenure of this program, failing which my admission stands cancelled. Date : Place :
Signature : ______________________________

Name - _________________________________ Class - _________________________________

Schedule for Post Graduate (M.E.) admission process for 2013-2014 Will be declared shortly.

Submit the Application form along with DD to Office or send it to the following address. Postal Address: The Principal, K.B.P. College of Engg. & Poly., Satara. Sadar Bazar Camp Satara Near Sainik School. PIN -415001