Shridhar App Form

Form No.
___________________
SHRIDHAR UNIVERSITY
(Established U/S 2(f) of UGC Act, 1956 by Rajasthan Legislative Assembly)
Pilani – Chirawa Road, Pilani (Rajasthan) 333031 India
Website: http://www.shridharuniversity.ac.in
E-Mail: info@shridharuniversity . ac . in
Phone: 91-1596-510000 Fax 91-1596-510002
REGISTRATION FORM
(Duly filled form with enclosures must reach to Admission Officer at above address)
Programme Applied For Session 201 - 201

(Please “√ “mark in appropriate box)
Affix Passport Size
Diploma UG PG Research
Photograph duly
attested by candidate
Title of the Programme……………………………………………………………….
(Select from Page 4)
1. Full Name in Capital Letters : (As in X Certificate)
2. Date of Birth DD/MM/YYYY
3. Nationality: (Write I for Indian and O for others) If ‘O’ Specify ____________________________
4. Gender: (Write M for Male and F for Female)
5. Category: (Write G for General, S for SC, T for ST and O for OBC)
6. Phone No.:___________________________________Mobile No.:______________________________________

e-mail address: _______________________________________________________________________________
7. Father’s Name: ________________________________Occupation:_____________________________________

Annual Income: ________________________________Phone No.:______________________________________
8. Mother’s Name: ________________________________Occupation:_____________________________________
9. Local Guardian Name & Relationship with candidate: _________________________________________________
10. Do you require Hostel Accommodation? (YES / NO):__________________________________________________

11. Address:
Correspondence Address Permanent Address
Pin code: Pin code:
1
12. If Foreigner/NRI, Passport No. _________________________________________________________________
13. Name of the School / College last attended with city location:
___________________________________________________________________________________________
14. Academic Records (X Onwards):

(a)
Name Of Exam Subjects Board / University Year of Percentage Remark
Passing / CGPA
Class X or
equivalent
Class XII or
equivalent
Graduation
Post Graduation
Any other
(Specify)
Candidate who have done XII with PCM fill following for admission to B.Tech. degree
Name Of Subject Marks Obtained Maximum Marks PCM %

Physics(P)
Chemistry(C)
Mathematics(M)
(b) Incase of gap in years, provide justification with proof:
_______________________________________________________________________________________________
(c) Have you appeared in any National or State level Entrance Examination in current year? If YES
submit relevant documents as per Checklist no. 10:
_________________________________________________________________________________________________________
(d) In the absence of National or State level scores you are required to appear in Shridhar University
Entrance Examination (SUEE)
(e) Are you currently enrolled for any Certificate/Diploma/Degree programme in any other institute/
University? If YES give details.
_______________________________________________________________________________________________
15. Are you currently employed? YES NO
If YES, you are required to submit relevant documents as specified in enclosure no. 09.
16. To improve our reach, we will be thankful if you could fill up the following questionnaire:
How did you come to know about Shridhar University and programs offered by Shridhar University?
Source Detail
Newspaper /Magazine / Journal (Give Name)
Shridhar University website / E-mail
Recommended by Faculty / Staff (Give Name)
Recommended by your friend (Give Name)
Google / Yahoo Searches and alerts
Others (specify such as Twitter / Face book / Orkut etc.)
2
DECLARATION BY APPLICANT
I,........................................................................................................... , declare that all the

information given in this application form is true to the best of my knowledge. I assure that I shall
abide by all the rules and regulations of the university, which are in vogue now as well as those,
which come into force from time-to-time. I further assure that I shall do nothing inside or outside
the university that goes against the discipline and orderly working of the university. I understand
that if (1) any information herein is found to be incorrect, (2) I am found indulging in any act of
indiscipline or (3) I fail to pay the dues in time, I shall be liable to any punishment as awarded by
the University, which may even include striking off my name from the rolls of the University.
Place: ___________________ Signature: _______________________

Date: ___________________ Name: __________________________
Important Instruction: Candidate is advised to keep a photocopy of duly filled form with relevant
enclosures and should check university website regularly for information update.
CERTIFICATE FROM THE PARENT/GUARDIAN
I,…………………………., father/mother/guardian of ……………................... , who is a

candidate for admission to the University; certify that I am the bonafide parent / guardian
of the candidate. I assure that the candidate and I shall abide by all the rules and
regulations of the University, which are in vogue now as well as those, which may come
into force from time-to-time. Also, all the required fees shall be paid in time.
Date: ___________________ Signature of

Place: __________________ the Parent/Guardian
Checklist
Important: Please ensure that you have enclosed the following documents / information, without which your application will
be considered as incomplete and rejected. You must also ensure that the enclosures are appended in the same order as
given below. Please Tick (√) against all those items / documents you have enclosed.
1 Demand Draft for the requisite registration fee. D. D. No.:___________________

Dated: _________________ for Rs. 1,100/- drawn from any Bank in favour of Shridhar University
and payable at Pilani or Chirawa.
(Write your Name and Application Number on the backside of DD)
2 One attested photocopy of X pass / Matriculation / Secondary School Leaving Certificate
3 One attested photocopy of XII pass / Senior Secondary School Leaving Certificate
Attested photocopies of all mark sheets and provisional / final degree of UG.
4 (For Admission in PG Programme)
5 Attested photocopies of all mark sheets and provisional / final degree of
PG. (For Research Programme)
6 One attested photocopy of OBC / SC / ST certificate by competent authority.
7 Enclose 6 (six) passport size photographs by putting inside an envelope and your name
written on the envelope.
8 In case you are seeking Lateral Entry to Second year of the B.Tech/Diploma Programme attaches
Provisional / final certificate including mark sheets of the ITI/Diploma /B.Sc. Programme undergone
by you.
9 If you are employed, attach details of employer (Name, Address, and Contact No.), your
work experience, NOC / Sponsorship letter from employer for enrolling in this university.
10 If appeared in any Entrance Examination in Current Year for admissions attach hall ticket and
score card. e.g. AIEEE/JEE/CAT/MAT/GATE etc.
11 One attested copy of any other document like marriage certificate, Gazette notification, for correct
name Purpose, research guide details for Ph.D.
3
Programmes Offered:
S.No. Diploma/Degree Programme Name Eligibility Duration

Diploma Programmes
1 Diploma Civil Engineering X Pass or Equivalent 3 Years
2 Diploma Computer Science & Engineering X Pass or Equivalent 3 Years
3 Diploma Electrical & Electronics Engg. X Pass or Equivalent 3 Years
4 Diploma Electronics & Comm. Engg. X Pass or Equivalent 3 Years
5 Diploma Mechanical Engineering X Pass or Equivalent 3 Years
6 Diploma Mining Engineering X Pass or Equivalent 3 Years
7 Diploma Fashion Technology X Pass or Equivalent 3 Years
8 Diploma Military Science X Pass or Equivalent 3 Years
Undergraduate Programmes
9 B.Tech. Civil Engineering XII PCM or equivalent 4 Years
10 B.Tech. Computer Science & Engineering XII PCM or equivalent 4 Years
11 B.Tech. Electrical & Electronics Engg. XII PCM or equivalent 4 Years
12 B.Tech. Electronics & Comm. Engg. XII PCM or equivalent 4 Years
13 B.Tech. Mechanical Engineering XII PCM or equivalent 4 Years
14 B.Tech. Mining Engineering XII PCM or equivalent 4 Years
15 BBA Business Administration XII or equivalent 3 Years
16 BCA Computer Application XII or equivalent 3 Years
17 B.Com (Hons) Commerce XII or equivalent 3 Years
18 B.A. Media Studies XII or equivalent 3 Years
19 B.A. Social Work XII or equivalent 3 Years
20 B.Sc. Environmental Science XII PCM / PCB 3 Years
21 B.Sc. Physics, Chemistry, Maths XII PCM or equivalent 3 Years
22 B.Sc. Zoology, Chemistry, Botany XII PCB or equivalent 3 Years
23 LLB Law Graduate or equivalent 3 Years
Post Graduate Programmes
24 M.Tech. Computer Science & Engineering B.Tech. in CSE/IT 2 Years
25 M.Tech. Software Engineering Any B.Tech./M.Sc./MCA 2 Years
26 M.Tech. Environmental Engineering Any B.Tech./M.Sc. 2 Years
27 M.Tech. Geo Informatics B.Tech. (Civil)/M.Sc. 2 Years
(Geo Informatics)
28 M.Sc. Geo Informatics B.Sc. (Any Branch) ,BCA, 2 Years
BA (Geography)
29 M.Pharm. Pharmaceutics B.Pharm. or equivalent 2 Years
30 M.Pharm. Pharmacognosy B.Pharm. or equivalent 2 Years
31 MBA Marketing, HR, IT, Finance Graduate or equivalent 2 Years
32 MCA Computer Application Graduate or equivalent 3 Years
33 MA Media Studies Graduate or equivalent 2 Years
34 MA Social Work Graduate or equivalent 2 Years
35 MA Child Care & Education Graduate or equivalent 2 Years
36 LLM Law LLB or equivalent 2 Years
Doctoral Programmes
37 Ph.D. ** Engineering, Management, Science, Post Graduation in Minimum 3
Commerce, Law, Humanities Relevant Branch Years
** If you have a Guide/Supervisor for research enclose Biodata with a concern letter, details of your papers / books
(If any) published /pattern held etc

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Form No.

Programme Applied For Session 201 - 201

1. Full Name in Capital Letters : (As in X Certificate)

2. Date of Birth DD/MM/YYYY

4. Gender: (Write M for Male and F for Female)

6. Phone No.:___________________________________Mobile No.:______________________________________

7. Father’s Name: ________________________________Occupation:_____________________________________

8. Mother’s Name: ________________________________Occupation:_____________________________________

9. Local Guardian Name & Relationship with candidate: _________________________________________________

10. Do you require Hostel Accommodation? (YES / NO):__________________________________________________

Pin code: Pin code:

14. Academic Records (X Onwards):

Name Of Subject Marks Obtained Maximum Marks PCM %

(b) Incase of gap in years, provide justification with proof:

15. Are you currently employed? YES NO

I,........................................................................................................... , declare that all the

Place: ___________________ Signature: _______________________

CERTIFICATE FROM THE PARENT/GUARDIAN

I,…………………………., father/mother/guardian of ……………................... , who is a

Date: ___________________ Signature of

1 Demand Draft for the requisite registration fee. D. D. No.:___________________

S.No. Diploma/Degree Programme Name Eligibility Duration

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6. Phone No.:_Mobile No.:____

7. Father’s Name: Occupation:_____

8. Mother’s Name: Occupation:_____

Place: _ Signature: _____