M.S.
RAMAIAH SCHOOL OF ADVANCED STUDIES
Postgraduate Engineering and Management Programme
Application Form
Year of Entry: Part-Time Course
M.Sc.[Engg.] MBA Corporate M.Sc.
Full-Time
Affix Passport Size Photo
Name of the Applicant
Please write the name in BLOCK letters as per SSLC marks card or equivalent record.
Organisation
(For Corporate M.Sc course only)
Form 65
Ver: 7
Date: 01-06-2011
Page 1 of 4
1.
Personal Details Blood Group Nationality
Date of Birth
Correspondence Address (Term time address):
Permanent Address:
PIN: Telephone No:e-mail:
Ph.
PIN:
Ph.
2. Year of Entry
Courses (Please tick appropriate item) FullTime Part-Time Corporate M.Sc
Award of Degree
M.Sc in [Engg.] / PgD / MBA
Please indicate the order of preference of the course:
S. No 1
2 3 4 5 6 7 8 9 10 11 12 13
Courses Aircraft Design
Automotive Engineering Automotive Product Design Automotive Electronics Advanced Manufacturing Technologies Advanced Medical Electronics
Order of Preference
S.N o
14 15 16 17 18 19 20
Courses
Machinery Design Machine Tool Design and Technologies Product Design Real Time Embedded Systems Rotating Machinery Design Signal Processing and Communication Technologies Strategic Product Design Management VLSI System Design MBA in Engineering Operations MBA in Finance & Accounting MBA in Human Resource Management
Order of Preference
Commercial and Retail Design Computer Animation and Games Development Computer Science and Networking Digital Signal and Image Processing Engineering and Manufacturing Management Electrical Machines and Power Engineering Electronics Systems Design Engineering
21 22 23 24
25
Technology and Engineering Management ( M.Sc.[Engg.] in TEM for Corporates only)
Form 65
Ver: 7
Date: 01-06-2011
Page 2 of 4
3.
(Please tick appropriate item)
Academic Details
B.E or Equivalent M.Sc B.Sc Course / Main Subject Educational Institution/ College / University Year From To Grade/ Class Technical Diploma / Equivalent Others (Please Specify)
S.No 1 2 3
4.
S.No 1 2 3 4
Work Experience
Organization and Job Title Brief description of work Duration
(months)
Part-time/ Full-time
5.
References
Please give details of two people who have been involved in supervising your recent academic work. If you have not been in education for a number of years please give the name of your current employer instead of one academic referee. When required, referees will be contacted by mail, fax or telephone.
First Referee Name: Address :
Second Referee Name: Address :
PIN: Telephone number: E-mail:
PIN: Telephone number : E-mail:
6. a b c d
Sponsorships (Please tick appropriate item)
I will be responsible for my fees I shall be supported by a family member I shall be supported by my government I shall be supported by my employer
If (c) or (d) is ticked, state to what extent you will be financed and give the address of your employer/Government:
Form 65
Ver: 7
Date: 01-06-2011
Page 3 of 4
7.
Additional Information
Please provide any relevant information, which may help the admission committee with your selection.
Signature
Date
Instructions to Applicants:
Filled in applications should be sent to Manager- Admissions along with the following: 1. Documents and fees to be submitted along with application: Sl. No. 1 Category For ALL admissions 1. 2. 3. 1. 2. 1. 2. 3. 1. 2. 3. Fees and Photocopies of Documents Application and prospectus fee in the form of a DD Registration fee in the form of a DD Caution deposit in the form of DD (at the time of admission) 10 and 10+2 Marks cards Degree certificate 10 / 10+2 Marks card Diploma certificate Experience certificate (Min 3 Yrs) 10 and 10+2 Marks cards Degree Certificate Experience certificate (Min 3 Yrs)
Engineering Graduate
Diploma holders
4 1. 2. 3.
Degree other than Engineering (B.Sc., B.A, etc)
ONLY photocopies of the above documents should be submitted. The Original documents should be produced at the time of admission for verification. DD must be drawn in the favor of M S Ramaiah School of Advanced Studies- Bengaluru
2. Application and Prospectus Fee: `.500.00 3. Registration Fee: ` 11,000.00 Note: 1. 2.
Incomplete applications and applications without the prescribed fees will not be considered for admissions. In case admission is not offered or the applicant has not joined the course, the registration fees will be returned after 8 weeks from the date of commencement of the course.
Contact Details:
Manager-Admissions M.S.Ramaiah School of Advanced Studies #470 P, Peenya Industrial Area, 4th Phase, Peenya, Bengaluru 560058. India For Office Use: e-mail: [email protected] Ph.No: (080) 49065555 Fax: (080) 42111205 Website: www.msrsas.org
Form 65
Ver: 7
Date: 01-06-2011
Page 4 of 4
