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* Denotes mandatory field

Title*

(Mr./Ms./Mrs/Dr.)

Name*

(In CAPITAL letters and as in candidate's class X mark sheet or equivalent)

Date of Birth* Place of Birth * Blood Group *

(in DD/MM/YYYY format) (city name)

Gender* F M Height* (in centimeters) Weight* (in KG)

Marital Status* Married Unmarried

Mobile No.* Email ID*

Permanent Address*

City* State*

Pin Code*

Mailing Address: (If different from Permanent Address)

City State

Pin Code

Instructions

1. Write in CAPITAL LETTERS only within the box.

2. Application form fee need to paid by DD only. Drawn in favour of "MIT Art, Design and Technology University" payable at Pune.

3. Kindly write your name and program name on back side of DD

4. Application form with out DD will be rejected

5. Kindly address the envelop to "The Registrar, MIT ADT University" Rajbaug, Next to Hadapsar, Loni Kalbhor, Pune - 412 201, India

Personal Details

Affix your latest

passport size

photograph

duly attested

by you.

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MIT-ADTUNIVERSITY

A leap towards World Class Education

PUNE, INDIARajbaug, Next to Hadapsar, Loni Kalbhor, Pune - 412 201, India.

Email: admissions@mituniversity.edu.in | www.mituniversity.edu.in

Under the Act of MIT Art, Design and Technology University Act, Mah. XXXIX of 2015

PUNE, INDIA

MIT Art, Design & Technology University

Admission Application Form for Academic Year 2018 - 19

Domicile and Category details (Kindly tick mark in front of appropriate option)

Open Domicile Maharashtra Domicile

(out of Maharashtra)Category Details for Maharashtra Domicile students (Kindly tick mark in front of appropriate option)

General S.C. S.T. DT - A (Denotified Tribes) OBC

NT - B (Nomadic Tribes) NT - C (Nomadic Tribes) NT - D (Nomadic Tribes)

Program applied for:

Kindly select program from the list:

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MIT Vishwashanti Sangeet & Kala Academy (MIT-VSKA)(Application Form Fee Rs. 1000/-)

Bachelor of Performing Art (BPA)(4 yrs Program)

Master of Performing Art (MPA) (2 yrs Program)

Diploma Program in Performing Art (1 yr. program)

Certificate Program in Performing Art (3 weeks /6 months)

MIT School of Film, Television & Performing Art (MIT-FTPA)(Application Form Fee Rs. 2000/-)

M Sc. in Film Making (2 yr. program)

MA in Film Making (2 yr. program)

FACULTY OF SOCIAL SCIENCES & HUMANITIES

MIT International School of Broadcasting & Journalism (MIT-ISBJ)(Application Form Fee Rs. 1000/-)

Bachelor of Arts (BA) (3 yrs Program)

PG Diploma in Video Production (1 yr. program)

M. A. (2 yrs. program)

B.Sc. in Film Making (3 yrs. program)

BA in Film Making (2 yr. program)

MIT School of Fine Art & Applied Art (MIT-SFA)(Application Form Fee Rs. 1000/-)

Bachelor of Fine Arts (4 yrs Program)

Sculpture

Metal work

MIT School of Education & Research (MIT-SER) (Application Form Fee Rs. 1000/-)

M. A. Education (2 yrs. program)

PG Diploma in Guidance & Counselling (1 yr. program)

Diploma in Pre-primary Teacher's Training (1 yr. program)

Certificate Course

ICT Skills- Basic & Advanced

Public Speaking Skills

Creative Writing

Master of Fine Arts (2 yrs Program)

Applied Art

Painting

FACULTY OF ART

Ceramics Sculpture

Metal work

Applied Art

Painting

Ceramics

PG Diploma in Film making (1 yr. program)

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FACULTY OF DESIGNFACULTY OF DESIGN

MIT Institute of Design (MIT-ID) (Application Form Fee Rs. 3000/-)

MIT College of Food Technology (Application Form Fee Rs. 1000/-)

Maharashi Ved Vyas MIT School of Vedic Sciences(Application Form Fee Rs. 1500/-)

B. Sc Integral Psychology (3 yrs. program)

PG Diploma in Vedic Sciences and Applications (1 yr. program)

M.Sc. (Vedic Sciences and Applications) (2 yrs. program)

M.Sc. (Vedic Sciences & Applications with Research) (3 yrs. program)

MBA Design Management (2 yrs. program)

Diploma in Automotive Clay Sculpting (2 yrs. program)

Certificate program in Automotive Clay Sculpting (8 months program)

Bachelor of Design (4 yrs. program)

Master of Design (2 yrs. program)

MBA Fashion Management & Marketing (2 yrs. program)

MIT School of Architecture (Application Form Fee Rs. 3000/-)

Bachelor of Architecture (5 yrs. program)

FACULTY OF TECHNOLOGY

MIT School of Bioengineering, Sciences and Research (Application Form Fee Rs. 1500/-)

B. Tech. - Bioengineering (4 yrs. program)

Integrated M. Tech. - Bioengineering (5 yrs. program)

B. Tech. Food Technology (4 yrs. program)

FACULTY OF SOCIAL SCIENCES & HUMANITIES

M. Tech. Food Technology (2 yrs. program)

FACULTY OF DESIGNFACULTY OF MANAGEMENT

MIT College of Management (Application Form Fee Rs. 1000/-)

BBA (3 years program)

BBA - Global (3 years program)

Executive MBA (2 years program)

Master of Business (2 yrs. program)Project and Construction Management

M. Tech. - Construction Management (2 yrs. program)

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Aerospace Engineering (AE)

B. Tech. (4 yrs. program) M. Tech. (2 yrs. program)

B. Tech. in Civil Engineering (CE): M. Tech. in Civil Engineering (CE):

Civil Engineering

CE -Transportation Engineering

CE -Structural Engineering

CE -Infrastructure Engineering

CE -Construction and Project Management

B. Tech. in Computer Science and Engineering (CSE) M. Tech. in Computer Science and Engineering (CSE)

Computer Science and Engineering

CSE - Intelligent Systems

CSE - Systems and Engineering

CSE - Networks and Security

Computer Science and Engineering

CSE - Intelligent Systems and Analytics

CSE - Networks and Security

CSE - Embedded Systems and Internet of Things

B. Tech. Electronics & Communication Engineering (ECE)

M. Tech. Electronics & Communication Engineering (ECE)

ECE -Electronics and Communication Engineering

ECE –VLSI and Embedded Systems Engineering

ECE –Communications and Signal Processing Engineering

ECE -Microelectronics and VLSI Design

ECE -Signal and Image Processing

ECE -Signal Processing and Communication Engineering

B. Tech. Information Technology (IT) M. Tech. Information Technology (IT)

IT - Information Technology

IT - Data Analytics

Information Technology

IT - Cyber Security

B. Tech. Mechanical Engineering (ME) M. Tech. Mechanical Engineering (ME)

ME - Mechanical Engineering

ME - Energy Engineering

ME - Mechatronics and Automation

ME - Design Engineering

ME - Energy Engineering

ME - CAD-CAM

ME - Mechatronics and Automation

ME - High Speed Mass Transportation Engineering

Integrated Programme [ B.Tech + M.Tech. ] (5 Years) in ALL Specialisation of Engineering.

B. Tech. - Marine Engineering (4 yrs. program)

Maharashtra Academy of Naval Education and Training (Application Form Fee Rs. 1500/-)

FACULTY OF MARITIME STUDIES

B. Sc. - Nautical Science (3 yrs. program)

MIT School of Engineering (Application Form Fee Rs. 1200/-)

FACULTY OF ENGINEERING

Father's Name*

Mother's Name*

Address* Pin Code*

City* State*

Mobile No* Email ID

Parent Details

Total Family Income (tick mark)

Less than Rs. 5 lakhs per annum Rs. 10-15 lakhs per annum Rs. 20-25 lakhs per annum

Rs. 05-10 lakhs per annum Rs. 15-20 lakhs per annum More than Rs. 50 lakhs per annum

Local Guardian Details

Name*

Address*

Pin Code*

City* State*

Occupation* Relationship with Student*

Mobile No* Landline No* (with STD code)

Email ID

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Educational and Work Experience Details

Education Details

Sr. No.

Class Institute / SchoolBoard / University Examination Body

Year of Completion

% (on a scale of 100) or CGPA (on

1 scale of 1-45)

Major Subject

City State

Work Details (If any)

Do you have work experience? Yes No Type (Full time / part time / self employed)

Company

Designation Function

City* State* Pin Code*

Reporting Person Name Designation

Your Responsibilities CTC (INR/p.a.)

List of achievements, awards / honours or scholarships in sports, extra-curricular activities, and / or in community services

Other Details (Transfer student, re-applicant or anything else you would like us to know)

Statement of purpose (about 150-300 words)

Documents required along with application form (self attested photo copy)

Mandatory Documents Any other documents (if applicable)

1. 10th or equivalent mark sheet 9. Education Gap Certificate-Notarize (if applicable)

2. 10th or equivalent passing certificate 10. Entrance Exam Score Card (if applicable)

3. 10+2 or equivalent mark sheet 11. Domicile Certificate

4. 10+2 or equivalent passing certificate 12. Nationality Certificate

5. Graduation mark sheet 13. Caste Certificate (if applicable)

6. Graduation degree certificate 14. Caster Validity Certificate (if applicable)

7. School / college leaving certificate 15. Non-creamy layer Certificate (if applicable)

8. Migration certificate 16. Work Experience Certificate (if applicable)

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Annexure I - Affidavit by the student (to be submitted along with application form)

I (full name of the student)

s/o d/o Mr. /Mrs/ Ms. having been admitted to

(name of the institution), have received a copy of the UGC Regulations on Curbing the Menace of Ragging in Higher Educational Institutions, 2009 (hereinafter called the "Regulations") carefully read and fully understand the provisions contained in the said Regulations.

2. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.

3. I have also, In particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware or the penal and administrative action that is liable to be taken against me in case I am found guilty of or abetting ragging, actively or passively, or being part of a conspiracy to promote ragging.

4. I hereby solemnly aver and undertake that

a) I will not indulge in any behaviour or act that may be constituted as ragging under clause 3 of the regulations.

b) I will not participate in or abet or propagate through any act of commission or omission that may be constituted as ragging under clause 3 of the Regulations.

5. I hereby affirm that, if found guilty of ragging, I am liable for punishment according to clause 9.1 of the Regulations, without prejudice to any other criminal action that may be under any penal law or any law for the time being in force.

6. I hereby declare that I have not been expelled or debarred from admission in any institution in the country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging and further affirm that, in case the declaration is found to be untrue, I am aware that my admission is liable to be cancelled.

Declared this day of month of year

Signature of deponent

Name

Address Tel./Mobile No.

Verification

Verified that the contents of this affidavits are true to the best of knowledge and no part of the affidavit is false and nothing has been concealed or misstated therein.

Verified at (Place) this the (day) of

(month), (year).

Signature of deponent

Annexure II - Affidavit by Parent/Guadian (to be submitted along with application form)

I Mr. / Mrs. / Ms.

(full name of parent/guardin/father/mother) guardian of,

(full name of student) having been admitted to

(name of the institution) have received a copy of the UGC Regulations on Curbing the Menace of Ragging in Higher Educational

Institutions 2009, (hereinafter called the "Regulations") carefully read and fully understand the provisions contained in the said Regulations.

2. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.

3. I have also, in particular, perused clause 7 and clause 9.1 Regulations and am fully aware of the penal and administrative action that is liable to be taken against may ward in case he/she is found guilty of or abetting ragging, actively or passively, or being part of a conspiracy to promote ragging.

4. I hereby solemnly aver and undertake that

a) My ward will not indulge in any behavior or act that may be constituted as ragging under clause 3 of the Regulations.

b) My ward will not participate in or abet or propagate through any act of commission or omission that may be constituted as ragging under clause 3 of the Regulations.

5. I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according to clause 9.1 of the Regulations, without prejudice to any other criminal action that may be taken against my ward under any penal law or any law for the time being in force.

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I certify that the information furnished in this application form is to the best of my knowledge and belief. I also authorise MIT Art, Design and Technology University, Pune to carry out any kind of verification of academic and / or employment details given in my application. In case any discrepancy MIT Art, Design and Technology University, Pune holds the right to reject the application / admission.

I understand that nothing in this application form guarantees admission, any type of grant / scholarship and / or any type of commitment on the part of MIT Art, Design and Technology University, Pune. It will entirely be at the discretion of MIT Art, Design and Technology University, Pune to accept or reject this application.

I have read and understood the minimum eligibility criteria of the program on the MIT Art, Design and Technology University, Pune on website. I understood that if I do not meet the minimum eligibility criteria, my application to MIT Art, Design and Technology University, Pune will stand annulled.

Demand Draft Number and Date Amount of DD

Drawn in Bank and Branch

6. I hereby declare that my ward has not been expelled or debarred from admission in any institution in the country on account of being found quality of, abetting or being part of a conspiracy to promote, ragging; and further affirm that, in case the declaration is found to be untrue, the admission of my ward is liable to be cancelled.

Declared this day of month of year

Signature of deponent

Name

Address Tel./Mobile No.

Verification

Verified that the contents of this affidavits are true to the best of knowledge and no part of the affidavit is false and nothing has been concealed or misstated therein.

Verified at (Place) this the (day) of

(month), (year).

Signature of deponent

Declaration

Application Form Payment Details

1. The application fee paid is non-refundable and non-transferable under any circumstances.

2. Batch transfer is not permitted. In special cases if allowed the students will be required to pay the requisite transfer fee.

3. The University reserves the right in make any changes / amendments to terms and condition of admission at anytime.

4. Student is required to inform the University about any changes in his/her contact details including permanent/Postal address, email id at any point of time.

5. The University may make mandatory the submission of any certificate or documents before or at the time of the admission or afterwards, for the purpose of admission or otherwise, as decided by the University.

6. University reserves the right to cancel admission if student fails to submit relevant documents or otherwise if fails to fulfil any condition.

7. Student should keep himself/herself well versed with the updates in the University through out notice boards/website. University is not responsible for any individual intimation of information.

8 You are advised to keep a photocopy of the complete application form.

9. Forms once rejected will not be reconsidered and form cost will not be refunded.

10. You cannot apply more than once for the same program in one admission year.

11. MIT ADT University dose not take any responsibility for delay or loss of the material in post/transit.

Date Place

(in dd/mm/yyyy format)

Applicant's Name

Applicant's Signature

Rules and Regulations

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