UNIVERSITY Form No. Regn. No. AL-FALAH UNIVERSITY · Copy of 10th Class Certiﬁcate / Marksheet Copy of 12th Class Certiﬁcate / Marksheet If you have ever been found using unfair

Code 01 Bachelor of Technology (B.Tech), 4-year course

Code 02 Bachelor of Technology (B.Tech), lateral entry in second year

AL-FALAH UNIVERSITYUniversity with 'A' Grade NAAC - UGC Accredited Institutions

Faridabad - 121004, Haryana

APPLICATION FORMACADEMIC SESSION 2014-2015

Regn. No.Form No.

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1.

2.

3.

4.

5.

Age

6.Religion Mother Tongue

8.

10.

7. Category: SC/ST/OBC/General

9.

Nationality

Male/Female State

11. Address: Present

P.O Pin Code

Distt State

Phone No.

Mobile No.

E-mail Address:

All courses are approved by AICTE as mentioned in prospectus.

Address: Permanent

P.O Pin Code

Distt State

Phone No.

Mobile No.

E-mail Address:

CodeName of the Candidate: Mr./Ms. (In Block Letters) (in English)

Name of the Candidate: (in Hindi)

Name of the Father: (in English)

Name of the Father: (in Hindi)

Name of the Mother: (In Block Letters) (in English)

Date of Birth (in Christian Era), (Based on Matriculation/High School Certificate)

Course applied for

DD MM YYYY

- -

AL-FALAHU N I V E R S I T Y

1997

Extra Curricular Activities

Documents to be enclose with this form

17.

15.

16.

Documents to be submitted at the time of Admission (If selected for Admission)

Other Information:

If you are employed give details

Copy of 10th Class Certificate / MarksheetCopy of 12th Class Certificate / Marksheet

If you have ever been found using unfair means in any examination and /or reported to have

misbehaved give details

If you have been convicted in any case or any case is under trial under the IPC give details

Declaration

I hereby solemnly declare that the information given is true and correct to the best of my knowledge and belief.

I understand that my candidature is subject to the conditions laid by the Al-Falah University . I further declare that I am not involved in any criminal case and no such case is pending against me in any court of law. I shall

abide by the rules and regulations of the Al-Falah University and shall not do anything contrary to discipline and good

governance.I further certify that I have submitted genuine and true documents issued to me by the concerning Board/

University; in case if any documents found bogus/fake/forged. I/We will be responsible and suitable action

as per rule may be initiated/taken against me.

Signature of Candidate

Father’s Occupation

(a) AIEEE Rank & Roll No. (If appeared)

(b) Have you appeared in any other entrance exam for engineering, mention name

Education Qualification:

(I ) (ii) ( i i i)

18.

Signature of Guardian/Parents

No.S. Exam Passed Board/University Year Div. % age of

Marks Subjectoffered

Roll No.

No.S. Exam Passed Board/University Year Div. % age of

Marks Subject

Class X

2. Class 10+2

3. Diploma in Engg.Branch

4.

offered Roll No.

1.

Others

1. Marksheet/Certificate (10+2) or Diploma

10th 2. Marksheet/Certificate

3. Character Certificate

4. Migration Certificate

5. Medical Certificate

6. Affidavit by Parents/Students/Guardianas per AICTE Rules & Regulation 2009

7. Gap Affidavit if Applicable

Annual Income

13.

12.

14.

19.

Faculty of Engineering & Technology

Mechanical Engineering

Electronics & Communication Engineering

Computer Science Engineering

Electrical & Electronics Engineering

Mechanical & Automation Engineering

Civil Engineering

Bachelor of Technology

For B.Tech. course: Please mark your choice of branches as preference 1, 2, 3 and so on.

NOTE: Center choice of Entrance test by student mark your choice of center.

Faridabad, Dhauj (University Campus)

Patna (Bihar)

Jamshedpur (Jharkhand)

Azamgarh (U.P)

Srinagar (J&K)

Signature of Student

(For Office Use Only)

Session ___________________________Registration No. ____________________________________

Roll No. ___________________________ Date of Registration ____________________________

Fee Details _____________ Fee ______________ Fee Deposited ________________ Reciept No.

Balance __________________________________due date ___________________________________

Signature of Admission Officer Signature of Principal

(Formerly as Al-Falah School of Engineering & Technology)('A' Grade NAAC- Accredition Institution)

1. All registrations/admission are Provisional subject to Confirmation by admission Committee/University (filling up of this form does not given any right to appear

in Entrance Exam/Admission).

2. Attach only duly self attested photocopies of the relevant documents.

Original to be submitted as and when required.

If this form is Downloaded from our Website, it should be accompanied by Rs 500/- cash or DD drawn in

The Application form duly completed may be submitted to any of the following:-

1. 274-A, Al-Falah House, Jamia Nagar, Okhla, New Delhi-110025, Mob. +91-9540303395

2.

Al-Falah University, Faridabad-121004 (Haryana), Ph. 0129-4254605, +91-9818834908

ADMIT CARD FOR OFFICE USEEntrance Test for B.Tech. 2014-15 in

Al-Falah University University with ‘A’ Grade NAAC - UGC Accredited Institutions


Form No.

Name of Applicant ____________________________________________________________________

Father’s Name ________________________________________________________________________

Date of Examination __________________________ Time of Examination ______________________

Roll No. ______________________________________ Exam Centre ____________________________

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Signature of Student Controller of Examination

favour of Al-Falah University payable at New Delhi.

ADMIT CARD FOR STUDENT Entrance Test for B.Tech. 2014-15 in

Al-Falah University University with ‘A’ Grade NAAC - UGC Accredited Institutions


Form No.


Father’s Name ________________________________________________________________________



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ADMIT CARD FOR CENTER (OFFICIAL)Entrance Test for B.Tech. 2014-15 in

Al-Falah UniversityUniversity with 'A' grade NAAC - UGC Accredited Institutions Photograph


Form No.


Father’s Name ________________________________________________________________________



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