Survey. No. 123 & 124, MIT-WPU Campus, Paud Road, Kothrud, Pune - 411 038.

Phone: - 020-25703400 Fax 020-25442770, Website: https://mitwpu.edu.in, Email: [email protected]

Application form for seeking admission for Academic Year 2024-2025

School of Engineering
PRN 1262243174 Faculty
and Technology

B.Tech Mechanical
Academic Level ENGINEERING (UG) Program Engineering (Robotics
and Automation)

Class/Std. FYBTech -Rob&Auto Admission Category OPEN

Seat Type All India Quota Domicile All India Quota

Sir/Madam,
I am applying for admission for ENGINEERING (UG) program under the School of Engineering and
Technology at Dr. Vishwanath Karad MIT World Peace University [MIT-WPU], Pune for the academic
year 2024-2025 . The details of my candidature are as below.

Personal Information

Ankur Kumar
1) Student Name : ( Name as per previous
mark-sheet)

2) Gender (M/F/T) : Male 3) Blood Group : B+

4) Category : OPEN 5) Nationality : INDIAN

ankurkumar8785ak@gma
6) Mobile No. : 917410714928 7) Email Id :
il.com

8) Present Address : Plot No 1351, Gda Layout India, Karnataka, Kalaburagi (Gulbarga), Gulbarga,

State : , Pin Code : 585102

Plot No 1351, Gda Layout India, Karnataka, Kalaburagi (Gulbarga), Gulbarga,

9) Permanent Address :
Kalaburagi (Gulbarga)

State : Karnataka, India Pin Code : 585102

10) Aadhar No. : 292518658552 11) Passport No. :

12)Sports(Y/N) if ‘Yes’,
name of sport :
Foreign Students Information [Applicable for NRI/PIO/OCI/FN students]

Particulars Number Issue Date Expiry date

Passport

Visa (Visa Type-)

Police Verification [RP]

Exam/ Result Details:

I. Educational Details [Attach a photocopy of mark-sheet(s)]:

Name of Board/ Month & Year Total Marks/ Total Marks/

Class Exam. Seat No
University of Passing Credits earned CGPA out-off

Central Board Of
Secondary
10th std. 03/2024 432 500
Education
(Cbse)

Karnataka Board
Of The Pre-
12th std. 03/2024 513 600
University
Education
II. 12th PCMB/ Technical Vocational Subject Obtained [If out of 200,pl. convert marks in out 100] :
Physics : 83 / 100 Chemistry : 93 / 100 Mathematics : 87 / 100

Biology : __ / 100 Tech. Voc : __ / 100 Eligibility Marks :

III. Qualifying entrance examination details [Attach a photocopy of mark-sheet(s)] :
Exam Application ID Marks/Percentile earned Marks/Percentile out off

PERA CET Score 0 100

Information as per previous Transfer/ Leaving Certificate :

1) Name of previous
college/ School Chimalgi Pu College
attended :

2) Date of birth : 27/01/2006 3) Place of Birth : Samastipur

4) Religion : 5) Caste & Sub Caste : Baniya-Baniya

Parent's Information
1) Father's Name
Surname : Mahto First Name : Buland

Middle Name : Kumar Mobile No : 7019636040

Occupation : GOVERNMENT JOB Employment Sector : Central Railways

Organization Name &

Designation : Station Manager NA
Address :

bulandkumar750@gmail.
Email ID : Alternate Contact No : 7019636040
com
2) Mother's Name
Surname : Kumari First Name : Mamta

Middle Name : Mobile No : 8431285166

Occupation : HOME MAKER Employment Sector :

Organization Name &

Designation : NA
Address :
3) Guardian's Name
Surname : - First Name : -

Middle Name : - Mobile No :

 **** DECLARATION ****
I, hereby, declare that :
1) I have not been debarred from appearing any examination held by any Government constituted or
statutory examination authority of India.
2) I have not been involved or no prosecution is pending against me regarding copying in examination or
any case of misconduct at any University.
3) In the middle of the academic year, I shall not ask for transfer from MIT-WPU to any other University or
from allotted existing branch to another branch under any circumstances.
4) The information furnished in the application form/admission record are true/ correct to the best of my
knowledge. If any of the information provided by me found incorrect, my admission shall be cancelled, and I
shall be liable for disciplinary action in accordance with rules and regulations of the MIT-WPU.
5) I will abide by the rules and regulations in force at present as well as those may be enacted and enforced
in future by the University, so long as I am the student of MIT-WPU.
6) I will do nothing either inside or outside the university that will interfere with the ordinary governance and
discipline of the university.
7) After completion of this academic year @ MIT-WPU, If I failed in the examinations and not found eligible
for admission to higher class, I shall contact in person; for completing further formalities.
8) I will remain regular in all respect and attend all the theory lectures and practical throughout the year. I
am also aware about the University timings/ shift timings and if my overall attendance is less than 90% my
academic term will not be granted.
9) In case I fail to pay the fees in time, I may not be allowed to appear the classes, respective exam that is
due and I will not object to such decision taken by the university.
I have read and agreed for the above terms and conditions.

Student's Signature
Date :___/___/______
Ankur Kumar

---- FOR OFFICE USE ONLY ----

Signature with Date : Signature with Date :

Form verified by : Fees verified & received by :

 UNDERTAKING BY STUDENT AND PARENTS
I/We the undersigned Mr./Mrs. Ankur Kumar am/are, father/mother /parent /guardian of Mr./Ms.Buland
Kumar Mahto ,of Class: REGULAR Year of ENGINEERING (UG) Branch: B.Tech Mechanical
Engineering (Robotics and Automation), my/our ward having been admitted to Dr. Vishwanath Karad
MIT World Peace University, Pune. I/We have read and are fully aware of the following regulations and
norms of the University and hereby undertake to strictly abide by the same.

For Student:
1. That, I shall attend the classes' right from the first day of the Term as per the Time Table.
2. That, minimum attendance required as per the MIT-WPU is 90% for granting of the Term. I shall attend
all the Theory and Practical classes sincerely and regularly without fail for achieving excellence in
Academics. I know that no special consideration is given even on Medical grounds without due certificate
form registered medical practitioner.
3. That, I shall not involve directly or indirectly in any kind of RAGGING and anti-social activities. I am fully
aware that ragging is an offence punishable by the law, resulting in imprisonment and / or heavy penalty. If
found involved in any such activity directly or indirectly, I shall not only be expelled from the University, but
the matter will be reported to the appropriate police authorities, for further action.
4. That, I am required compulsorily to submit assignments and appear for Tests in every subject with full
preparation, for grant of Term.
5. That, I shall complete all the assignments after thorough preparation & I shall neither copy the same from
others nor show others to copy my assignments.
6. That, I shall read and follow all the instructions given by the University from time to time through its
Notice Boards, SMS, E-mail, MIT-WPU Website, Announcement Systems, Oral Communications, etc.
7. That, I shall strictly maintain punctuality while attending all the Theory and Practical Classes.
8. That, I shall put-on my University I-Card on every day without fail and will attend the classes in full
University uniform on the specified days and on special occasions.
9. I shall dress my hair properly and put on a neat, decent formal dress of Trouser and Shirt / Salwar Kurta
(for girls) every day; other than uniform days.
10. I shall not wear any objectionable / indecent dress / clothes like low waist jeans, 3/4th jeans or any
shabby looking tight dress during or after the working hours of the University, on the campus.
11. I shall participate in all curricular, co-curricular, extra-curricular, social, cultural and adventure activities
at my own risk. In case of any unfortunate event, accident, any type of injury or fatal casualty, University /
Management / Faculty / Staff will not be held responsible under any circumstances. I understand that any
breach of the above rules, regulations and norms may result in disciplinary action and even non-granting of
my Academic Term.
12.I understand that, any admission secured as a reserved category candidate given against quota,
reserved for backward class category is purely provisional and can be cancelled if the caste certificate is
cancelled / rejected / invalidated by any Govt. Authority, admission authority or the University and subject to
submission of Caste Validity Certificate and / Non-Cream Layer Certificate (as applicable).
13. I will not directly or indirectly get involved in any such behavior which would adversely affect my image
and/or the image of the University, failing which I shall be liable for the disciplinary action which may result
into cancellation of my admission.
14. I have read all the rules and regulations framed by the University regarding Discipline and Code of
Conduct which are in force and made applicable by the Management of MIT-WPU, Pune and I promise to
abide by the same.
 I agree with the contents of Undertaking signed
Student's Full Name & Signature
by my ward and advise him/ her to abide by the
Ankur Kumar
above clauses.

Place :____________ Full Name & Signature of the Parent's/Guardian's

Date :___/___/______ Mahto Buland Kumar
 MIT-WPU
UNDERTAKING ON CODE OF CONDUCT
PENALTY / PUNISHMENT ON VIOLATION OF
CODE OF CONDUCT / RULES & REGULATIONS
CODE OF CONDUCT

1. University Identity Card i) Fine of Rs. 500/-.

a) Students are required to put on Student Identity ii) No entry in the classroom or use of facilities for
Card all the time within the campus premises. the day.

2.Attendance & Academic rules

a) Students are expected to attend each and every
Lecture, Tutorial and Laboratory practical sessions.
However, due to contingencies, 90% attendance is
mandatory.In addition, 10% grant of exemption in
attendance based on extraordinary cases like
i) In case, the attendance of the student falls below
sickness, hospitalization, death of immediate family
75%, then the said student will not be eligible to
member.Furthermore, 5% exemption in attendance
appear in the Term - End Examination.
can be granted by Vice Chancellor (VC) on the
ii) Loss of Term.
recommendations of Dean as per the statutes of the
iii) Debarment from receiving any scholastic award
University.
and/or Scholarship of the University.
b) Use of cell phones during Lectures, Tutorials,
iv) Cancellation of Admission.
Laboratory Practicals, Examinations is strictly
prohibited.
c) Involvement in Unfair Practices such as copying,
plagiarism etc. is strictly prohibited and will be dealt
as per the rules of the Academic and Examination
ordinances of the University.

3. Dress Code
a) Students are required to attend the classes in full
University Uniform on specified days and on special
occasions of the School/ University, including
N a t i o n a l D a y s , G u e s t L e c t u r e s , S e m i n a r s , i) Attendance won't be marked for the entire day for
Conferences and other gatherings. the first instance.
b) On other days, descent formal dress to be worn ii) Social Project duration of 15 - 20 hours for
by the students.(Tight, shabby and revealing clothes, second and subsequent instances.
Sleeveless and Off-Shoulder Tops, T-Shirts without
collars, Low waist jeans, Half-pants, shorts, short
skirts, slippers and objection able/indecent dresses
are not allowed).

i) Zero Tolerance Policy.

ii) Suspension till pending enquiry.
4. Anti-Ragging
iii) Disciplinary Action including rustication.
a) Ragging, in any form, is strictly banned in the
iv) Case may be reported to Police authorities for
University campus and hostel premises as per law.
legal action as per the provisions of Indian Penal
Code.
5. Alcohol, Drugs and Smoking
a) The unlawful possession, consumption, purchase
i) Zero Tolerance Policy.
or distribution of alcohol, cigarettes, e-cigarettes,
ii) Suspension till pending enquiry.
illicit drugs, controlled substances (including
iii) Disciplinary Action including rustication.
stimulants, depressants, narcotics, or hallucinogenic
iv) Case may be reported to Police authorities for
drugs) or paraphernalia or the misuse of prescription
legal action as per the provisions of Indian Penal
drugs including buying, sharing or consuming is
Code.
strictly prohibited in the University campus and
hostel premises.

6. Assault, Endangerment or Infliction of

i) Suspension till pending enquiry.
Physical Harm
ii) Disciplinary Action including rustication.
a) Physical restraint, assault or any other act of
iii) Case may be reported to Police authorities for
violence or use of physical force against any
legal action as per the provisions of Indian Penal
member of the campus or any act that threatens the
Code.
use of physical force

7. Discrimination, Including Harassment, Based i) Zero Tolerance Policy.

on a Protected Class ii) Suspension from attending classes pending
a) Discrimination, including harassment, based on enquiry.
an individual's sex, race, colour, age, religion, iii) Disciplinary actions as per the directives of the
national or ethnic origin, sexual orientation, gender Discipline committee.
identity or expression, pregnancy, marital status, iv) Case may be reported to Police authorities for
medical condition, veteran status, disability or any legal action as per the provisions of Indian Penal
other legally protected classification. Code

8. Disorderly Conduct
a) Excessive noise, which interferes with classes,
school offices, neighboring societies or other i) Debarment from receiving any scholastic award
activities. and/or Scholarship of the University.
b) Unauthorized entry into a restricted area or a ii) Suspension from attending classes pending
closed meeting. enquiry.
c) Conduct that restricts or prevents faculty, staff or iii) Disciplinary actions as per the directives of the
student employees from performing their duties, Discipline committee.
including interruption of meetings, classes or events. iv) Repeat instances may result in expulsion from
d) Any other action(s) that result in unreasonable the University with no refund of Fee paid.
interference with the learning/working environment
or the rights of others

9. False Representation
a) Provide false information or make
misrepresentation to any school office, forgery,
i) Expulsion from the University with no refund of
alteration, or unauthorized possession or use of
fee paid.
school documents, records, or instruments of
identification, forged or fraudulent communications
(paper or electronic mail).

10. Fire Safety i) Debarment from receiving any scholastic award

 and/or Scholarship of the University.
ii) Suspension from attending classes pending
a) Tampering, interference, misuse, causing damage enquiry.
and/or destruction of fire safety and fire prevention iii) Disciplinary actions as per the directives of the
equipment. Discipline committee.
iv) Repeat instances may result in expulsion from
the University with no refund of Fee paid.

i) Suspension from attending classes pending

enquiry.
11. Theft, Vandalism, or Property Damage ii) Disciplinary actions as per the directives of the
a) Theft, negligent, intentional, or accidental damage Discipline committee.
to personal or school property. iii) Twice the Full Recovery towards the damage.
b) Defacing of Campus property by means of iv) Debarment from receiving any scholastic award
Banners, Chalking and Posters. and/or Scholarship of the University.
v) Repeat instances may result in expulsion from
the University with no refund of Fee paid.

12. Weapons and Fireworks i) Zero Tolerance Policy.

a) Possession or use of firearms including rifles, ii) Expulsion from the University with no refund of fee
shotguns, handguns, air guns, and gas-powered paid.
guns and all ammunition or hand-loading equipment, ssss
knives etc. iii) Case may be reported to Police authorities for
b) Possession or use of fireworks, dangerous legal action as per the provisions of Indian Penal
devices, chemicals, or explosives. Code.

13. Parking of Vehicles in the campus

a) No vehicle will be allowed in the campus without
authentic stickers provided by the MIT-WPU. i) Fine of Rs.500/-, each time, for parking vehicles
b) Area for parking of staff vehicles and student's other than the allotted area.
vehicles are defined and allotted. ii) Tyres of the vehicle will be flattened by the
c) The students should park their vehicles in the parking/security authorities if vehicles found on
allotted area only. wrong parking allotment or vehicle parked in
d) The student should not park their vehicles in improper manner.
parking slot/area allotted for staff of MIT-WPU in any iii) Two-wheeler should not be parked on side stand,
circumstances. otherwise parking/security authorities will flatten the
e) If the Parking is full and there is no vacant space, tyre.
then the student should park the vehicles outside
MIT-WPU campus at their own risk.
I have read all the above-mentioned code of conduct / rules and regulations and penalty / punishment on
violation of the same as framed by the University regarding Discipline and Code of Conduct which are in
force and made applicable by the Management of MIT-WPU, Pune and I promise to abide by the same.
I have also informed the contents of the above-metioned Undertaking to my parents/guardian.

Student's Full Name & Signature

Place :____________
Ankur Kumar
Date :___/___/______
(PRN No.1262243174)
 ANTI-RAGGING - UNDERTAKING
I, Mr/Ms. Ankur Kumar [Students Name], Son of Mr./Mrs. Buland Kumar Mahto [Parent's Name] Class:
REGULAR of ENGINEERING (UG) program, Branch: B.Tech Mechanical Engineering (Robotics and
Automation) having been admitted to Dr. Vishwanath Karad MIT World Peace University, Pune,
and
I, Mr./Mrs. Buland Kumar Mahto [Parent's Name], father /Mother /Parent /Guardian of Mr./Ms. Ankur
Kumar [Student's Name], Class: REGULAR of ENGINEERING (UG) program, Branch: B.Tech
Mechanical Engineering (Robotics and Automation) , my ward having been admitted to Dr.
Vishwanath Karad MIT World Peace University, Pune.
1. We have received a copy of the UGC Regulations on “Curbing the Menace of Ragging in Higher
Educational Institutions 2009”, (hereinafter called the “Regulations”). We have carefully read and fully
understood the provisions contained in the said Regulations.
2. We have, in particular, perused clause 3 of the Regulations and am aware as to what all constitute
ragging.
3. We have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of
the penal and administrative action that is liable to be taken against me / my ward in case I / my ward found
guilty of or abetting ragging, actively or passively, or being part of a conspiracy to promote ragging.
4. We hereby solemnly aver and undertake that:
1. I / My ward will not indulge in any behavior or act that may be constituted or considered as ragging under
clause 3 of the Regulations.
2. I /My ward will neither participate nor abet or propagate through any act of commission or omission that
may be constituted as ragging under clause 3 of the Regulations.
5. We hereby affirm that, if found guilty of ragging, I/ my ward shall be liable for punishment according to
clause 9.1 of the Regulations, without prejudice to any other criminal action that may be taken against me /
my ward under any penal law or any law in force at that time.
6. We 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 / my ward’s admission
is liable to be cancelled. Declared this on ___________ day, date:___/___/______
We have read and agree with the contents of Undertaking signed by me/my ward.

Signature of Father /Mother /Parent /Guardian

Student's Full Name & Signature
with name
Ankur Kumar
Mahto Buland Kumar

Place :____________
Date :___/___/______
 SELF-DECLARATION
I have passed qualifying examination prescribed for the programme mentioned in this application form for
which I wish to take admission. Also, I confirmed that I am fulfilling the eligibility criteria of the programme
as per the norms of the MIT-WPU (45% for reserved category, 50% for open category/As applicable),
failing which my provisional admission will stand cancelled and I will not dispute the cancellation of my
admission.
I shall produce the educational certificates / mark sheet in original for credential verification within a week
from the date of my admission / on or before 31st Aug. of this calendar year, failing which I shall forfeit my
admission claim/ seat.
I am aware that my admission is provisional in nature & it will be confirmed upon fulfilling the eligibility
criteria & payment of full fees as prescribed by the MIT-WPU.
I have read and agreed for the Fees Refund Policy defined by MIT-WPU which is in line with the UGC
refund policy against cancellation of Admission.
I/We undertake that I/We, in case cancellation of admission of may ward, shall accept the decision of the
University about the refund of fees as the rules mentioned.
I shall read and follow all the instructions given by the University from time to time through its Notice
Boards, SMS, E-mail, MIT-WPU Website & any other official communications.
I shall participate in all curricular, co-curricular, extra-curricular, social, cultural and adventure activities at
my own risk. In case of any unfortunate event, accident, any type of injury or fatal casualty, University /
Management / Faculty / Staff will not be held responsible under any circumstances.
I understand that, any admission secured under backward class reserved category is purely provisional and
can be cancelled if the caste certificate or caste validity certificate is cancelled / rejected / invalidated by
any Govt. Authorities and will be confirmed subject to fulfilling of eligibility criteria, submission of mandatory
documents in the Admin Office of the University along with the Caste Validity Certificate and Non- Cream
Layer Certificate (as applicable).
I will not directly or indirectly get involved in any such behavior which would adversely affect my image
and/or the image of the University, failing which I shall be liable for the disciplinary action which may result
into cancellation of my admission.
I hereby declare that my admission may be cancelled or I may be suspended, expelled or debarred from
the University on account of being found guilty of, abetting or being part of a conspiracy / common offs such
as mass bunking, hooliganism, attempt to defame MIT-WPU on Social media / print and electronic media,
misleading and enticing fellow students to stage illegitimate protest against university on account of false
assumptions, misinterpretation of university rules and regulations.
I also declare that any issue related to admissions, student affairs, fees, academics, examinations,
administration etc. shall be resolved bilaterally only (between students /parents and university authorities)
through university grievance redressal mechanism and I or my parents shall not involve any third party
(individual or organizations / associations) for necessary resolution of the grievance. Non adherence to this
declaration may result in suspension or expulsion from the university.
I have not been debarred from appearing any examination held by any Government constituted or statutory
examination authority of India.
I have not been involved or no prosecution is pending against me regarding copying in examination or any
case of misconduct at any University.
In the middle of the academic year, I shall not ask for transfer from MIT-WPU to any other University or
from allotted existing branch to another branch under any circumstances.
The information furnished in the application form/admission record are true/ correct to the best of my
knowledge. If any of the information provided by me found incorrect, my admission shall be cancelled, and I
shall be liable for disciplinary action in accordance with rules and regulations of the MIT-WPU.
After completion of this academic year @ MIT-WPU, If I failed in the examinations and not found eligible for
admission to higher class, I shall contact in person; for completing further formalities.
I/ We are aware that MIT-WPU is a self-financed state private university & abide to pay full fees of the
program as per the fee payment schedule prescribed by the MIT-WPU.
I understand and accept that, I may not be allowed to attending the lectures / practical / Placement process
/ appearing the Examinations and or representing the University in co-curriculum and extra co-curriculum
activities if I fail to fulfill the eligibility criteria and or payment of fee on or before due date.
We have agreed with the contents of Student-Self Declaration signed by me & my ward.

Signature of Father /Mother /Parent /Guardian

Student's Full Name & Signature
with name
Ankur Kumar
Mahto Buland Kumar

Place :____________
Date :___/___/______