Registration No.

:
(Office Use only)

ANNA UNIVERSITY, CHENNAI

CHENNAI-600 025, INDIA

APPLICATION FORM FOR ADMISSION TO

MASTERS’ DEGREE PROGRAMMES
OFFERED AT UNIVERSITY DEPARTMENTS
UNDER FOREIGN NATIONALS CATEGORY
(Academic year 2011-2012 Only)

For Admission to ___________________________ Degree Please paste (do

not pin) 3.5x4.5
cm size recently
Choice of Branch: 1._______________________ taken Colour
2._______________________ Photograph and
sign across the
3._______________________ lower part of the
4._______________________ photo

Choice of Campus: College of Engineering Guindy (CEG)

Alagappa College of Technology (ACT)
Madras Institute of Technology (MIT)
School of Architecture & Planning (SAP)
Registration fee:

Bank Draft No. Date Amount Issuing Bank

US $200

A.DETAILS OF THE CANDIDATE:

1. Name of the candidate (Capital letters)

2. Candidate’s Address for Correspondence:--------------------------------------------------

--------------------------------------------------
--------------------------------------------------
--------------------------------------------------

Phone No. : -------------------------------------------------

e-mail : -------------------------------------------------

3. Gender: Male/Female Date-of-Birth:

Day Month Year

 4. Name of the Father :______________________________
5. Name of the Mother : ______________________________
6. Details of Qualifying degree:

Name of Register Name of the University Year of Medium of

Degree No. and Country Passing instruction

7. Details of Marks obtained in the qualifying degree.

Attach authenticated transcripts of grades / marks secured in the qualifying degree.

8. Name & Address of Local Guardian, if any:

Residence: ………………………. Office:………………………………
…………………………………….. ……………………………………..
…………………………………….. ……………………………………..
…………………………………….. …………………………………….
Phone: …………………………. Phone: ……………………………
Fax : …………………………. Fax : ……………………………
e-mail: …………………………. e-mail: ……………………………

9. Passport Details of the candidate:

Name of the Place of Date of
Nationality Passport No.
Candidate Issue Expiry

10. Foreign Residence address of parents for correspondence:

Residence: …………………………… Office:…………………………………

………………………………………... ………………………………………..
………………………………………… ……………………………………….
………………………………………… ……………………………………….
Phone: ………………………………. Phone: ………………………………
Fax : ……………………………….. Fax : ………………………………
e-mail: ………………………………. e-mail :………………………………

11. Full address of the country’s Embassy office in India

………………………………………………………………….
………………………………………………………………….
………………………………………………………………….
Phone: ………………………….
Fax: ………………………….
e-mail: ………………………….
2
12. Photo copies of the following documents are to be attached along with the
application.

1. Proof for the Citizenship of the candidate.

2. Passport of the candidate.
3. Qualifying mark list of the candidate: if the grades are produced, certificate
showing equivalent marks to grades should be submitted.
4. Valid Visa
5. PIO/OCI card (In case of Citizen of Indian Origin)
6. Provisional Degree Certificate.
7. Transfer Certificate.

3
 INSTRUCTION TO THE CANDIDATES UNDER FN CATEGORY
AT ANNA UNIVERSITY, CHENNAI, CHENNAI – 600 025, INDIA
1. ADMISSION REQUIREMENTS
1.1 Application
The application form may be downloaded from the website:www.annauniv.edu/cia/adm.php
1.2 Eligibility and Academic Qualifications
P.G. Programmes: Candidates to refer to Anna University, Chennai Website:
www.annauniv.edu/cia/adm.php

Extended Course Details:

For detailed specification of the courses of study refer to the Anna University,
Chennai Website: www.annauniv.edu/cia/adm.php
Note: Admission shall be offered only to the candidates who possess the
qualification prescribed against each course.
Any other relevant qualifications which are not prescribed against each programme
shall be considered for equivalence by the committee constituted by the Syndicate.
Admission to such degree shall be offered only after obtaining equivalence from
the Director (Academic Courses), Anna University, Chennai – 600025.
1.3. Registration Fee
A Bank Draft for US $ 200 drawn in favour of the Director, Centre for
International Affairs, Anna University, Chennai payable at New York drawn
from any Nationalised Banks of India or other International Banks with branches in
India should be submitted along with the application.

1.4. Last date for Receipt of Application

Application complete in all respects should reach the Director, Centre for International
Affairs, Anna University, Chennai-600 025, India on or before 15 July 2011

The admission is subject to the eligibility criteria prescribed by the

Academic Courses, Anna University, Chennai, India.
1.5 Selection of candidates :
1.5.1 Selection of the candidates will be done on first come first served basis subject to
availability of vacancies and production of the following documents:
1. Proof for the Citizenship of the candidate.
2. Passport of the candidate.
3. Qualifying mark list of the candidate: if the grades are produced, Certificates
showing equivalent marks to grades should be submitted.
4. Valid Visa.
5. Eligibility Certificate from Indian Embassy.
6. Provisional Degree Certificate.
7. Transfer Certificate.
1.5.2 Final allotment of the branch of study will be done after verification of the
certificates.

4
1.6 Payment of Tuition Fee
1.6.1 On receipt of the allotment order, the candidate has to pay the prescribed fee
immediately in the form of Demand Draft drawn in favour of the Director, Centre for
International Affairs, Anna University, Chennai payable at New York.

1.6.2 Fee Structure : (in US dollars)

Fee Fee payable in

Course / Branch payable one installment
every year per Course
M.E./M.Tech./M.Arch./MBA
US$ 4,000 US$ 8,000
Masters’ Programmes
MCA (6 Semesters) US$ 4,000 US$ 12,000

1.6.3 Fees once paid is not refundable.

1.7. Fitness:
Candidates have to submit a medical fitness certificate at the time of final allotment
as per Annexure-II.

2. GENERAL INFORMATION
2.1 Reporting to the University:
Normally, the academic session begins by July – August every year. Candidates
selected for admission are required to report to the respective Deans of the
campus concerned on the scheduled date mentioned in the allotment order. If the
candidate fails to do so, the offer of admission will automatically stand cancelled.

2.2 Other Fee: Fees applicable for Library, Examination, Students’ Co-operative
Society, Identity card(Smart card), etc should be paid in Indian rupees at the time
of admission or when ever required to pay as per the rules.

*************

5
 ANNEXURE - I
DECLARATION BY THE CANDIDATE
I, _________________________, hereby declare that all the particulars stated in this
application and enclosures are true to the best of my knowledge and belief. I have read
the Information Brochure and I shall abide by the terms and conditions therein. I am
aware that my admission will be provisional and in the event of my being found ineligible
at the time of reporting, my admission will be denied, if I am already admitted, my
admission will be cancelled. I am also aware that in all matters concerning admission,
the decision of Anna University, Chennai is final and I shall abide by it. I am fully aware
that as per the directions of the Hon’ble Supreme Court of India and Tamil Nadu
Prohibition of Ragging Act 1997, ragging is an offence and is banned in the Institutions
and anyone indulging in ragging is liable to be punished such as expulsion from the
Institution and/or rigorous imprisonment up to three years and/or fine up to Rs.25, 000/-

Place: Signature of the Candidate

Date: Name:

DECLARATION BY THE PARENT

I, ______________________, hereby declare that all facts given in the application by

the Candidate Mr. / Ms. ___________________________________ who is my son /
daughter are true and correct. In case, any particulars furnished in the application are
found to be incorrect at a later stage, I agree to forfeit the admission of my
son/daughter, no matter, at whatever stage of the course at that time. I hereby give an
undertaking to pay regularly all his/her dues to the University/Hostel till the completion
of his/her course of study. I also undertake the responsibility for his/her good conduct. I
am also aware that in all matters concerning admission of my son/daughter, the
decision of Anna University, Chennai is final and I shall abide by it. I am fully aware that
as per the directions of the Hon’ble Supreme Court of India and Tamil Nadu Prohibition
of Ragging Act 1997, ragging is an offence and is banned in the Institutions and anyone
indulging in ragging is liable to be punished such as expulsion from the Institution and/or
rigorous imprisonment up to three years and/or fine up to Rs.25, 000/-

Place: Signature of the parent

Date: Name:

6
 ANNEXURE - II

MEDICAL CERTIFICATE
(to be produced at the time of counseling)

Certified that I, Dr……………………………………………………………………

(IMC. Reg.No. …………………………………….) have this ……………………

day of ……………………………….2010/2011 examined the candidate whose

particulars are given below:

1. Name of the Candidate :

2. Name of the parent :

3. Sex : Male / Female

4. Age with date of Birth : …… years

Date Month Year

5. Identification Marks 1.

2.

6. Whether the candidate fulfils the

following standards : Normal If No, specify the defect

(a) General Fitness consists of Yes/No

Full Blood Test including HIV Test

Full Urine Test

Chest X-ray

ECG

Mental Retardness Test and

Other General Tests

(b) Vision : Yes/No

(c) Auditory functions : Yes/No

(d) Speech functions : Yes/No

7
7. Whether Physically Handicapped : Yes/No (If Yes specify the
defect
and the extent of
disability)

(i) Vision

(ii) Speech

(iii) Hearing

(iv) Limbs

8 OPINION : with the above clinical details

Please specify

Whether the candidate is physically

eligible to be considered for admission Yes/No (If No specify
in Engineering Colleges/Technical the reasons)
Institutions

Signature of the Candidate Signature of Regd.Medical Practitioner

Place: Register No. :

Date : Full Address: