APPLICATION FORM for

MIT-NAT 2017 ional Aptitude Test for the Academic Year 2017-18.

Last date for submitting the application form: 30th May 2017

Note:

MIT-NAT 2017 is applicable for all Professional programs at UG & PG level Admissions to MIT-ADT University, Pune.

MIT-NAT 2017 will be treated as qualifying exam for admission to MIT ADT University, Pune.

Eligibility Criteria:

Ÿ For Eligibility of respective courses please refer Information Brochure 2017-18.

MIT-ADTUNIVERSITY

A leap towards World Class Education

PUNE, INDIA(Established by Govt. of Maharashtra by MIT ADT University Act No. XXXIX of 2015)www.mituniversity.edu.in

PUNE, INDIA MIT Art, Design & Technology University

MIT NAT2017

Please select the program for which you are Applying

Page 1 of 5

UG Programmes PG Programmes

MIT School of Engineering, Pune

B. Tech (4-Years Program)

Civil Engineering (CE)

CE - Transportation Engineering

Computer Science & Engineering (CSE)

CSE - Networks and Security

CSE - Intelligent Systems

CSE - Systems and Engineering

Electronics & Communication Engineering (ECE)

ECE - VLSI and Embedded Systems Engineering

ECE - Communication and Signal Processing

Engineering

Information Technology (IT)

IT - Data Analytics

Mechanical Engineering (ME)

ME - Mechatronics and Automation Engineering

ME - Energy Engineering

Aerospace Engineering (AE)

Integrated Programmes (B Tech + M Tech) 5-Years

Program In all Specialization of Engineering

(Note : Write Name of Integrated Programme at above

Blank Space)

£

£

£

£

£

£

£

£

£

£

£

£

£

£

£

£.....................................................................................

M. Tech (2-Years Program)

CE - Structural Engineering

CE - Project & Construction Management

CE - Infrastructure Engineering

Computer Science and Engineering (CSE)

CSE - Networks and Security

CSE - Intelligent Systems and Analytics

CSE - Embedded Systems and Internet of Things

ECE - Microelectronics and VLSI Design

ECE - Signal Processing and Communication

Engineering

ECE - Signal and Image Processing

Information Technology (IT)

IT - Cyber Security

ME - Energy Engineering

ME - Mechatronics and Automation Engineering

ME - Design Engineering

ME - CAD-CAM

ME - High Speed Mass Transportation Engineering

£

£

£

£

£

£

£

£

£

£

£

£

£

£

£

£

£

Personal Detail:

Name of the Candidate:

Surname Name Middle name

Date of Birth (DD-MM-YYYY):

Gender: □ Male □ Female

Religion: □ Hindu □ Christian □ Islam □ other

Caste:

Category: □ Open □ SC □ ST □ OBC □ Other

Nationality: □ Indian □ NRI □ PIO/OCI □ Foreign

Contact Tel.: Place of Birth:

Email id:

Passport sizePhoto of the Candidate

Self-Attested

Candidate Signature

Parents Details:

Name of the Father / Mother:

Surname Name Middle name

Permanent Address:

Dist.: State:

Occupation: □ Service □ Business □ Other If Employed Designation: .......................................................................

Landline Number Mobile Number

Contact Tel. Number :

Email id:

Total Family Income:

□ □ □

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

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

Instructions

1. Write in CAPITAL LETTERS only within the box.

2. Write Correct & Required Information only .

3. Application form fee is INR 1200/-

4. Application form without Payment will be rejected.

5. Write your name and program name on backside of DD.

6. Address the envelope to "The Registrar, MIT ADT University" Rajbaug Campus, Loni Kalbhor- 412 201, Pune (MH), India.

Page 3 of 5Page 2 of 5

UG Programmes PG Programmes

MIT School of Bioengineering Science & Research, Pune

B. Tech (4-Years Program)

Bioengineering £

Integrated program

(B.Tech + M.Tech) (5-Years Program)

Bioengineering£

MIT College of Food Technology, Pune

B. Tech (4-Years Program)

Food Technology£

M. Tech (2-Years Program)

Food Technology£

Maharashtra Academy of Naval Education & Research (MANET), Pune

B. Tech (4-Years Program)Marine Engineering

B. Sc (3-Years Program)Nautical Science

£

£

MIT College of Management (MIT COM), Pune

BBA (3- Years Program)

BBA

BBA (IB)

BBA (Real Estate Management & Infrastructure)

£

£

£

£

£

£

Executive MBA (Part time) - (2 yrs program)

Master of Technology (M. Tech.) Construction Management (2 yrs Program)

Master of Business Administration (MBA)Project & Construction Management (2 yrs Program)

MIT International School of Broadcasting & Journalism (MIT ISBJ), Pune

Bachelor of Art (BA) (3- Years Program)Journalism & Mass Communication£

Master of Art (MA) (2- Years Program)Journalism & Mass CommunicationCorporate Communication Business Journalism

PGD (1- Year Program)Video Production

£££

£

MIT School of Film & Television (MIT-SFT), Pune

Bachelor of Art (BA) (3- Years Program)Film Making (Production Design & Art Direction /

Screen Play Writing

Bachelor of Science (B. Sc) (3- Years Program)Film Making (Sound Recording & Designing / Cinematography / Editing / Direction)

£

£

Master of Art (MA) (2- Years Program)Film Making (Production Design & Art Direction / Screen Play Writing)

Master of Science (M. Sc) (2- Years Program)Film Making (Sound Recording & Designing/ Cinematography / Editing / Direction)

PGD (1- Year Program)Film Making

£

£

£

Personal Detail:

Name of the Candidate:

Surname Name Middle name

Date of Birth (DD-MM-YYYY):

Gender: □ Male □ Female

Religion: □ Hindu □ Christian □ Islam □ other

Caste:

Category: □ Open □ SC □ ST □ OBC □ Other

Nationality: □ Indian □ NRI □ PIO/OCI □ Foreign

Contact Tel.: Place of Birth:

Email id:

Passport sizePhoto of the Candidate

Self-Attested

Candidate Signature

Parents Details:

Name of the Father / Mother:

Surname Name Middle name

Permanent Address:

Dist.: State:

Occupation: □ Service □ Business □ Other If Employed Designation: .......................................................................

Landline Number Mobile Number

Contact Tel. Number :

Email id:

Total Family Income:

□ □ □

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

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

Instructions

1. Write in CAPITAL LETTERS only within the box.

2. Write Correct & Required Information only .

3. Application form fee is INR 1200/-

4. Application form without Payment will be rejected.

5. Write your name and program name on backside of DD.

6. Address the envelope to "The Registrar, MIT ADT University" Rajbaug Campus, Loni Kalbhor- 412 201, Pune (MH), India.

Page 3 of 5Page 2 of 5

UG Programmes PG Programmes

MIT School of Bioengineering Science & Research, Pune

B. Tech (4-Years Program)

Bioengineering £

Integrated program

(B.Tech + M.Tech) (5-Years Program)

Bioengineering£

MIT College of Food Technology, Pune

B. Tech (4-Years Program)

Food Technology£

M. Tech (2-Years Program)

Food Technology£

Maharashtra Academy of Naval Education & Research (MANET), Pune

B. Tech (4-Years Program)Marine Engineering

B. Sc (3-Years Program)Nautical Science

£

£

MIT College of Management (MIT COM), Pune

BBA (3- Years Program)

BBA

BBA (IB)

BBA (Real Estate Management & Infrastructure)

£

£

£

£

£

£

Executive MBA (Part time) - (2 yrs program)

Master of Technology (M. Tech.) Construction Management (2 yrs Program)

Master of Business Administration (MBA)Project & Construction Management (2 yrs Program)

MIT International School of Broadcasting & Journalism (MIT ISBJ), Pune

Bachelor of Art (BA) (3- Years Program)Journalism & Mass Communication£

Master of Art (MA) (2- Years Program)Journalism & Mass CommunicationCorporate Communication Business Journalism

PGD (1- Year Program)Video Production

£££

£

MIT School of Film & Television (MIT-SFT), Pune

Bachelor of Art (BA) (3- Years Program)Film Making (Production Design & Art Direction /

Screen Play Writing

Bachelor of Science (B. Sc) (3- Years Program)Film Making (Sound Recording & Designing / Cinematography / Editing / Direction)

£

£

Master of Art (MA) (2- Years Program)Film Making (Production Design & Art Direction / Screen Play Writing)

Master of Science (M. Sc) (2- Years Program)Film Making (Sound Recording & Designing/ Cinematography / Editing / Direction)

PGD (1- Year Program)Film Making

£

£

£

How did you come to know about MIT-ADT University, Pune?

□ Magazine □ Website □ News Paper □ Relatives and Friends

□ Specify News Paper name, If any………………… □ Others

Mode of Payment: □ Card □ Net Banking □ Demand Draft of any Nationalized Bank

DD drawn in favor of "MIT Art, Design & Technology University" & payable at Pune

DD No.: ………………………………………, DD Amount.: …………………………………… Bank Name: .....................................................

Documents required along with application form (self-attested photocopy)

□ 1. 10th or equivalent mark sheet □ 5. Graduation mark sheet only for PG programs.

□ 2. 10th or equivalent passing certificate □ 6. School / college leaving certificate

□ 3. 10+2 or equivalent mark sheet* □ 7. Domicile Certificate

□ 4. 10+2 or equivalent passing certificate* □ 8. Nationality Certificate

Test City Preferences *: Choose Two Cities of your Preference

MIT NAT - 2017 Examination Dates

Month Dates Examination Time

May - 2017 £ 28th May

£ 12 pm to 02 pm

£ 03 pm to 05 pm June - 2017 £ 25th June

July- 2017 £ 16th July

Important Note : Select only one Exam Date & Exam Time Slot of your Convenience R

Terms and Conditions:

Before submitting the candidate's application form please ensure that:

Ÿ The application form is filled completely, incomplete form will not be accepted.

Ÿ The Photograph must be signed by the candidate.

Ÿ The candidate's name must be written identically everywhere and that they have signed in all the appropriate places

I, Mr. /Ms…………………………………………......................................................................................…….. have read the above rules

and regulations of the MIT ADT University, Pune. I hereby declare that all the information submitted / given is true and

correct to the best of my knowledge. I also agree to abide by the above mentioned rules and regulations of the University. I

will be liable for disciplinary action, in case I am found disobeying the orders or instructions given by the authorities of the

University.

Signature of the Candidate: ……………………………........................................................

Name of Candidate: …………………………….....................................................................

Signature of the Parent: ……………………………..............................................................

Name of Parent: ……………………………...........................................................................

Date: ………………………................

Place: ………………………..............

MIT-ADTUNIVERSITY

A leap towards World Class Education

PUNE, INDIA

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

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

MIT Art, Design & Technology University PUNE, INDIA

Ÿ Cumulative Percentage: Physics, Chemistry, Mathematics: ….........………%

Ÿ Cumulative Percentage: Physics, Chemistry, Biology: …................………%

Details of qualifying Examination:

Engineering Entrance Exams: □ MHT-CET □ JEE Main □ Uni-GAUGE GATE

Marine Engineering: □ IMU-CET □ MHT-CET □ JEE Main □ MANET-CET

Bio-Engineering □ NEET □ MHT-CET □ JEE Main

Food Technology □ NEET □ MHT-CET

Management Entrance Tests: □ CMAT □ MAT □ XAT □ CAT □ MHT CET (MBA)

□

Sr. No.Qualifying Examination Passed/Appearing

Reg. No/ Roll. No.Month & Year of Passing/Appearing

Marks obtained

State/ Country

Educational Details of the candidate:

Medium of Instruction: □ English □ Other

Mode of study: □ Regular □ Other

Page 5 of 5Page 4 of 5

Applicants Academic Records:

Examination Year of Passing Name of the College/ University State Mark Obtained %

SSC

HSC

Diploma

UG

Others

Ÿ Write Two City Codes of your Convenience : Preference - 1 Preference - 2

City Code City Name City Code City Name City Code City Name City Code City Name

1. Agartala 13. Cochin 25. Jabalpur 37. Simla

2. Ahmedabad 14. Coimbatore 26. Jaipur 38. Tiruvananthpuram

3. Allahabad 15. Dehradun 27. Kolkata 39. Varanasi

4. Amritsar 16. Delhi 28. Kota

5. Ananad 17. Gangtok 29. Ludhiyana

6. Aurangabad 18. Goa 30. Mumbai

7. Bengaluru 19. Gorakhpur 31. Nagpur

8. Bhopal 20. Gurudaspur 32. Nashik

9. Bhubaneswar 21. Guwahati 33. Patna

10. Bilaspur 22. Gwalior 34. Pune

11. Chandigarh 23. Hyderabad 35. Raipur

12. Chennai 24. Imphal 36. Ranchi

How did you come to know about MIT-ADT University, Pune?

□ Magazine □ Website □ News Paper □ Relatives and Friends

□ Specify News Paper name, If any………………… □ Others

Mode of Payment: □ Card □ Net Banking □ Demand Draft of any Nationalized Bank

DD drawn in favor of "MIT Art, Design & Technology University" & payable at Pune

DD No.: ………………………………………, DD Amount.: …………………………………… Bank Name: .....................................................

Documents required along with application form (self-attested photocopy)

□ 1. 10th or equivalent mark sheet □ 5. Graduation mark sheet only for PG programs.

□ 2. 10th or equivalent passing certificate □ 6. School / college leaving certificate

□ 3. 10+2 or equivalent mark sheet* □ 7. Domicile Certificate

□ 4. 10+2 or equivalent passing certificate* □ 8. Nationality Certificate

Test City Preferences *: Choose Two Cities of your Preference

MIT NAT - 2017 Examination Dates

Month Dates Examination Time

May - 2017 £ 28th May

£ 12 pm to 02 pm

£ 03 pm to 05 pm June - 2017 £ 25th June

July- 2017 £ 16th July

Important Note : Select only one Exam Date & Exam Time Slot of your Convenience R

Terms and Conditions:

Before submitting the candidate's application form please ensure that:

Ÿ The application form is filled completely, incomplete form will not be accepted.

Ÿ The Photograph must be signed by the candidate.

Ÿ The candidate's name must be written identically everywhere and that they have signed in all the appropriate places

I, Mr. /Ms…………………………………………......................................................................................…….. have read the above rules

and regulations of the MIT ADT University, Pune. I hereby declare that all the information submitted / given is true and

correct to the best of my knowledge. I also agree to abide by the above mentioned rules and regulations of the University. I

will be liable for disciplinary action, in case I am found disobeying the orders or instructions given by the authorities of the

University.

Signature of the Candidate: ……………………………........................................................

Name of Candidate: …………………………….....................................................................

Signature of the Parent: ……………………………..............................................................

Name of Parent: ……………………………...........................................................................

Date: ………………………................

Place: ………………………..............

MIT-ADTUNIVERSITY

A leap towards World Class Education

PUNE, INDIA

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

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

MIT Art, Design & Technology University PUNE, INDIA

Ÿ Cumulative Percentage: Physics, Chemistry, Mathematics: ….........………%

Ÿ Cumulative Percentage: Physics, Chemistry, Biology: …................………%

Details of qualifying Examination:

Engineering Entrance Exams: □ MHT-CET □ JEE Main □ Uni-GAUGE GATE

Marine Engineering: □ IMU-CET □ MHT-CET □ JEE Main □ MANET-CET

Bio-Engineering □ NEET □ MHT-CET □ JEE Main

Food Technology □ NEET □ MHT-CET

Management Entrance Tests: □ CMAT □ MAT □ XAT □ CAT □ MHT CET (MBA)

□

Sr. No.Qualifying Examination Passed/Appearing

Reg. No/ Roll. No.Month & Year of Passing/Appearing

Marks obtained

State/ Country

Educational Details of the candidate:

Medium of Instruction: □ English □ Other

Mode of study: □ Regular □ Other

Page 5 of 5Page 4 of 5

Applicants Academic Records:

Examination Year of Passing Name of the College/ University State Mark Obtained %

SSC

HSC

Diploma

UG

Others

Ÿ Write Two City Codes of your Convenience : Preference - 1 Preference - 2

City Code City Name City Code City Name City Code City Name City Code City Name

1. Agartala 13. Cochin 25. Jabalpur 37. Simla

2. Ahmedabad 14. Coimbatore 26. Jaipur 38. Tiruvananthpuram

3. Allahabad 15. Dehradun 27. Kolkata 39. Varanasi

4. Amritsar 16. Delhi 28. Kota

5. Ananad 17. Gangtok 29. Ludhiyana

6. Aurangabad 18. Goa 30. Mumbai

7. Bengaluru 19. Gorakhpur 31. Nagpur

8. Bhopal 20. Gurudaspur 32. Nashik

9. Bhubaneswar 21. Guwahati 33. Patna

10. Bilaspur 22. Gwalior 34. Pune

11. Chandigarh 23. Hyderabad 35. Raipur

12. Chennai 24. Imphal 36. Ranchi