Instructions for filling up the Application Form for DA-IICT PG ...

Instructions for filling up the Application Form for DA-IICT PG Admissions:
• You need to submit separate application forms and make separate payments if you
wish to apply for multiple programs.
• Item No. 1 – Mention your name exactly the way it is spelt in your board certificate (be
it surname first or name first)
• Every single detail of your qualifying degree is required. Specifically mention the
degree and the discipline so that your eligibility can be ascertained.
• GATE/CEED qualification is not mandatory for admission but if you have appeared in it
you should fill up the details. Based on an excellent GATE/CEED score you may be
eligible for Direct Admission or exemption from written test.
• (For MTech/MDes/PhD only) In order to fill up Item No. 11 (to indicate your research
interest, refer to the DA-IICT Information Brochure and the PG Admission Prospectus.
You are also welcome to select an area not listed in the prospectus if you have a
definite research idea in that direction.
Application
Fees:
Rs. 1000/- for applications received by post
By Demand Draft (with your name and program name written on the
reverse) drawn in favour of DA-IICT and payable at Ahmedabad.
• DD should be sent by post to DA-IICT at the following address:
PG ADMISSION COMMITTEE
DA-IICT
NEAR INDRODA CIRCLE
GANDHINAGAR
GUJARAT
PIN 382007
• Application Forms will stand rejected if the DD as detailed in the form does not reach
the Convener, PG Admissions, DA-IICT within 10 days of the submission of the
application but in any case no later than closing date of application submission.
• All applicants must write their name and program name on the reverse side of the
demand draft.
• For further clarification, you may send e-mail to Convener, Post Graduate Admission,
DA-IICT at pg_admissions@da-iict.org .

DA- IICT
Dhirubhai Ambani
Institute of Information and Communication Technology
Gandhinagar, Gujarat-382007
e-mail: pg_admissions@da-iict.org
APPLICATION FOR POST GRADUATE ADMISSION 2006-07
M Tech (ICT), MS (IT), M Des (Multimedia Design), Ph D
Please read the instructions given before filling up the Form.
Use only capital letters and black ballpoint pen.
Program applied for
1. Name (as in Board Certificate)
2. Gender (Tick √ ) 3. Date of Birth
Male Female DD MM YYYY
4. Address for Communication
_______________________________________________________________________
_______________________________________________________________________
City ___________________________State________________ Pin
5. STD code ___________Telephone ____________ Mobile No ________________
E-mail _____________________________
6. Degrees Obtained
Examination
Passed/
Appeared
Qualifying
Degree
Additional
Degree
(if any)
Degree & Discipline University/
Institute
7. a) GATE/CEED records (Tick one, if applicable)
Month &
Year
Reg. No. Year Subject Code All India Rank
b) Other Competitive (All India) Examination Score, if any
Percentile . or Score
Name of Exam __________________ Year__________ Score __________
% Marks/ Grade/ Class
(in the degree)

8. Attach a brief (typed) “Research Statement / Statement of Purpose”
(only for Ph D / M Des applicants respectively)
9. Mention three areas of research interest (for M Tech applicants only)
(Refer to the Information Brochure and the Admission Prospectus for the research areas)
i)
ii)
iii)
10. Research/ Professional Experience (Attach Separate Sheet with details)
Name of University/
Institute/ Organization
Period Nature of duties/
Position held
11. Details of the DD Attached
DD No ________________ Date ___________ Amount ____________
Bank & Branch _________________________
12. Declaration by the Applicant
Title of Dissertation/ Topic
of Research
I hereby declare that I am an Indian citizen and all the particulars stated in this application are true to the best of
my knowledge and belief. I have read the Information Brochure and the Admission Prospectus, and I shall abide
by the terms and conditions therein.
Place ______________________ ________________________
Signature of the Candidate
Date ______________________
(FOR OFFICE USE ONLY)
APPLICATION NO. REGISTRATION NO.