programmes 'o'-level 'a'-level or ‘o’ or - tezpur …...application forms...
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Programmes 'O'-Level 'A'-Level
Duration One Year
(Two Semester) One and Half Year (Three Semester)
Class Timings 2:00 pm to 6:00 pm
(Monday to Friday)
2:00 pm to 6:00 pm
(Monday to Friday)
Eligibility Criteria
10+2,
or
ITI certificate after class 10
Diploma in Engg. after 10+2 or
‘O’-level qualified or
Graduate degree in any discipline
Selection On the basis of past academic merit. On the basis of past academic merit.
Intake 30 20
Course fee Rs.5000/- per semester +
Rs.2000/- for Project work
Rs.6500/- per semester +
Rs.3000/- for Project work
Caution Deposit (Refundable)
Rs.3000/- Rs.3000/-
Important Dates:
Last Date of issuing admission forms 11-July-2019
Last Date of receiving filled in admission forms 11-July-2019
Displaying Selection List for admission 15-July-2019
Tentative Admission Dates 17-July-2019 to 22-July-2019
Commencement of Classes 05-Aug-2019
Application forms may be obtained from DOEACC Office, Department of Computer Science &
Engg. between 1:00 p.m. and 5:00 p.m. from 03-Jun-2019 to 11-July-2019 (On Working Days
only) by depositing an amount of Rs.50/- in cash or through Demand Draft in favor of Tezpur
University payable at Tezpur.
Application forms may also be downloaded from Tezpur University website www.tezu.ernet.in.
Downloaded forms must be submitted along with an amount of Rs.50/- in cash or through
Demand Draft in favor of Tezpur University payable at Tezpur.
(Contact No.: 03712-27-5361, 91-8486269199)
*Calls to the above numbers will be available only during office hours.
*Hostel Facility is not available for these courses.
NIELIT (Formerly DOEACC)
COMPUTER CENTRE::TEZPUR UNIVERSITY
APPLICATION FORM FOR ADMISSION TO ‘O’ / ‘A’ LEVEL COURSE
1. Admission sought for
(Please √ any one) ‘O’ Level / ‘A’ Level
2. Applicant's full name
(In Capital letters)
3. Father's Details
Name _________________________________________________________
Occupation _____________________________________________________
Contact No. ____________________________________________________
4. Mother's Name
5. Date of Birth (as per HSLC Admit Card)
(Attach HSLC Admit Card, self-attested)
6. Gender (Please √ ) Male / Female / Others
7. Marital Status (Please √ ) Married / Unmarried / Others
8. Category (Please √ ) Gen / SC / ST / OBC (Attach relevant certificate, self-attested)
9. Religion
10. Mobile Number
11. Email ID
12. Aadhar Card Number
(if any)
13. Address for
Communication
C/o ________________________________________________________
Landmark ___________________________________________________
Vill / Town / City______________________________________________
State_____________________ Dist.______________________________
P.O. ___________________________ Pin No. _____________________
For Office Use Only
1. Form Serial No.______________
2. Admitted on _______________________(Date of Admission)
3. Registered with Application No. _______________________________ & Registration No. _______________________from NIELIT
Affix one recent
Passport
Photograph
duly attested
14. Educational Qualifications (Starting from 10th Standard Onwards)
(Attach all relevant Mark sheets & Certificates, self-attested)
Name of Exam
Passed/Appeared
Board / University Year of
Passing
Division /
Class / Grade
% age / CGPA
obtained
15.
Are You Currently
Undergoing Studies,
elsewhere
Yes / No If Yes, Course Name ________________________________
Class / Level / Sem._________________________________
Name of the Institution ______________________________
16. Are You Currently
Employed
Yes / No If Yes, Please Specify _______________________________
________________________________________________
17.
Have you Completed
DOEACC ‘O’ Level Course
(For ‘O’ Level Applicant,
Please √ NA )
Yes / No / NA If Yes, Registration No. ______________________________
Grade Obtained ____________________________________
18. Any other information
Declaration
I…………………………………….. (Name of the Applicant), do hereby declare that all the statements
made above are true to the best of my knowledge and belief. If any of the above information
furnished by me in this form is found to be incorrect, fake, misleading or illegal at any point of
time, I will be solely responsible for any financial, social or legal action that may be taken
against me by the Centre / NIELIT at any point of time. Also if admitted, I agree to complete the
full term of the course and failing which, I shall forfeit the caution money deposited at the time
of admission.
Place:
Date: Signature of Applicant