Alliance College of Engineering and Design Application Form

Chikkahagade Cross, Chandapura-Anekal Main Road

Anekal, Bengaluru - 562 106, Karnataka, India
Tel.: +91 80 30938050/1/2/3
www.ced.alliance.edu.in

Regular
Year: Bachelor of Technology (B. Tech.) Entry:
Lateral

Indicate the order of preference from the engineering

branches given below: 1.

Civil | Mechanical | Electrical and Electronics | 2.

Electronics and Communication | Aerospace |
Computer Science |Information Technology 3.

Applicant’s information
Name: as per Xth mark sheet Mother Tongue:

Gender: Date of Birth: / /

(dd/mm/yyyy)
Affix photograph
Blood Group: Domicile: Category: GM SC ST OBC

Aadhaar No.:

Nationality: Indian NRI Foreign National (Citizenship)

Applicant’s contact details for correspondence

Address:

Pin Code: State: Country:

Tel. (Residence):
(with STD/ISD code)

Mobile:

E-Mail: Alternative E-Mail:

Parents’ contact details

Father Mother
Name:
Occupation:
Organization:
Designation:
E-Mail:
Mobile:
Permanent Address:

Pincode: State: Country:

Telephone: Office Residence

(with STD/ISD code)
Educational qualifications

Name of the Name of the

Name of the Year of Percentage
Examination/ University/ State Main Subjects Mode of Study
Institution Passing Scored
Degree Board

Full time
X Part time
Correspondence

Max. Marks
Subject %
Marks Obtained

Physics

Mathematics
Full time
Chemistry/Electronics/
XII Part time
Computer Science
Correspondence

Diploma Full time

[10+3] Part time
(if any) Correspondence

Undergraduate Full time

Degree [10+2+3] Part time
(if any) Correspondence
Entrance Examination Score
JEE (Main)/JEE (Advanced)/Karnataka CET/COMED-K/AUEET*/Other State Entrances (please specify)
Examination Date Registration Number Score/Rank Obtained
(if any) (Attach copy of rank certificate)

*AUEET: Alliance University Engineering Entrance Test

Statement of purpose
1. What motivates you to apply to the Alliance College of Engineering and Design, Alliance University?

2. Where did you first hear about Alliance College of Engineering and Design, Alliance University?
(you may choose a maximum of three options)

Google Alliance University Blog

Facebook Educational Website (eg. Shiksha.com, H T Campus, Indiacollegesearch.com etc)
Youtube Direct Mail
Linkedin Educational Fair
Twitter Friend/Recommendation/Referral
Radio Conference/Event/Open house
Newspaper Google Play/Apple App Store
Magazine Television Advertisements (TVC’s)
Hoarding Coaching Center (please specify)..............................................................
Brochure/Prospectus Television Advertisements (TVC’s)
Poster Others (please specify)..................................................................................
Employment History
(Please give details of your full-time employment history to date or other relevant professional experience)

Name and Address Work Experience

Designation and Responsibilities
of the Organization
From To In Months

Do you need hostel accommodation? Yes No

Declaration
1. I have read and understood the full requirements of the course, eligibility criteria, terms and conditions and
other important information as indicated in the Prospectus/website.

2. I confirm that the information furnished by me in this Application Form is true to the best of my knowledge. I
understand that any false or misleading statement given by me may lead to the cancellation of admission or
expulsion from the course at any stage.

3. I undertake to abide by the rules and regulations of the Alliance College of Engineering and Design as
prescribed from time to time. If I violate at any point of time any of the stipulated rules and regulations, then the
University is free to initiate appropriate disciplinary action against me.

Signature: Date:

Application Fee
Enclose along with your completed application form a non-refundable processing fee as applicable through
cash/online transfer/demand draft in favor of “Alliance University College of Engineering ” payable at
Bengaluru.

Checklist
1. Copies of the following documents to be enclosed: 2. Application Form Fee:
Standard X mark sheet/transcript Indian Nationals `1000/-
Standard XII mark sheet/transcript NRI/ SAARC Nationals `2000/-

Diploma mark sheets (if any) Foreign Nationals USD$50

Bachelor’s degree mark sheets (if any) DD No.:

Work experience certificates (if any)
Date:
Passport copy (For NRI / Foreign National )
Entrance exam scorecard Bank:
JEE (Main)/JEE (Advanced)/Karnataka CET/COMED-K/AUEET/Other State Entrances (please specify)