New Delhi

Application form for Online program

ADMISSIONS 2015/16

WINTER

  1. Do not send any attested copies of certificates with this form. Original and attested copies of degree certificates/ marksheets will be needed later.
  2. Incomplete application forms are likely to be rejected.
  1. Candidates who are in the final year of their qualifying programme will be considered for admission only if they have completed all requirements for award of the qualifying degree by 23December 2015 and if their provisional degrees are available before 23January 2016.
  2. This form must be accompanied by a demand draft of Rs 1450/-.
  3. Use capital letters wherever possible.

TYPE OR WRITE LEGIBLY IN ENGLISH

1.Name in full (as in 10+2 certificate):

2. (a) Address of the candidate for (b)Name and Address of Parent/Present

communicationGuardian (i.e. Permanenent Address)

City ______City ______

State ______Pin State ______Pin

3.Mobile No: ______

4.Alternate contact no: 5.E-mail: ______

6.Date of Birth: (as in School Leaving Certificate)

D D M M Y Y Y Y

7. GN/SC/ST/PH[†] 8. Sex (M/F/TG)

9. Blood Group ______RH Factor ______

10.Status of qualifying examination (B.Sc/ B.Tech etc) result:

(write A: Appeared and result awaited, P: Passed)

Exam Passed/ Appeared / Semester / Subjects/courses taken
(Please provide details) / Month/ Year / % Marks/Grade /Class obtained

11.Are you a sponsored candidate ? (Y/N)

12. If yes, indicate the name and address of the sponsoring agency:

13.Select the program you want to register

Certificate in Energy Infrastructure & Efficiencies
Certificate in Renewables Energy Resources and policies
Certificate in Renewable Energy”
Certificate in Software tools for energy analysis
PG diploma in Renewable Energy(note: one year duration)
Advance PG diploma in Renewable Energy(note: two years duration)

14.Declaration by the Applicant:

If selected for admission, I undertake to abide by the rules and regulations of TERIUniversity. I certify that the information given above is correct and I am aware that providing incorrect information in the application form may result in the cancellation of admission secured. I am further aware that, if the admission is secured before the results for the qualifying examination are published and if I fail to satisfy the minimum academic requirement for admission when such results become available, the admission will be cancelled. I also certify that I have not been convicted in any criminal case and that there is NO pending criminal case against me.

Place:______Date:______Signature of Applicant

Details of Demand Draft drawn in favour of “Registrar, TERIUniversity”, payable at New Delhi, enclosed with this application

Demand Draft No. ______Dated ______Amount Rs______

Bank Name______

[†] General/Scheduled Caste/Scheduled Tribe/Physically Handicapped