Form No.

MAHATMA EDUCATION SOCIETY’S

PILLAI’S COLLEGE OF ARCHITECTUREDr. K.M. Vasudevan Pillai Campus, Sector 16, New Panvel, Navi Mumbai, -410206Tel: 022 27456100 / 2745 1700 / 2748 3207, Fax: 022 2748 3208.Website: www.pica.ac.in

APPLICATION FORM FOR FIRST YEAR MASTER OF ARCHITECTURE(URBAN DESIGN)

PhotoTo,The PrincipalPillai’s College of Architecture

Sir / Madam,I seek admission to the course of Master of Architecture (Urban Design) at Pillai’s College of ArchitectureI agree to abide by all rules and regulations of the college.

FULL NAME AS IT APPEARS ON THE MARKSHEET OF QUALIFYING EXAMINATION

1.

Surname First Name

2. Father’s / Husband Name:

3. Mother’s Name:

4. Date of Birth: Male/Female Nationality

Category:5. SC/ST/DN/NT/NT1/NT2/NT3/OBC/SBC/VJ/OPEN

6. Marital Status:

CONTACT DETAILS

Address:

Tel. No: Mobile:

Email ID:

PLEASE INDICATE THE VALID CERTIFICATE THAT YOU WILL SEND

a) Mark sheets from First to Final year B.Arch

b) College Leaving Certificate

c) Degree Passing Certificate

d) Eligibility Certificate

e) GATE Score Card

f) Migration Certificate

Caste Certificateg)

h) Caste Validity Certificate

I) Non-Creamy Layer Certificate

j) Council Registration Certificate

k) Sponsorship Letter

PILLAI’S COLLEGE OF ARCHITECTUREDr. K.M. Vasudevan Pillai Campus, Sector 16, New Panvel, Navi Mumbai, -410206

Tel: 022 27456100 / 2745 1700 / 2748 3207, Fax: 022 2748 3208.Website: www.pica.ac.in

MAHATMA EDUCATION SOCIETY’S

ACKNOWLEDGEMENTForm No.

Received an application form for admission to the course of Master of Architecture (Urban Design)

for the A.Y. from

Ms. / Mr.:

Received By:

Date:

Score / Percentage University Year of Passing

GRADE

B.Arch.(Final Year)

SPONSORED: YES/NO

(If sponsored then attach an experience certificate and a sponsorship certificate in the given format)

PROFESSIONAL EXPERIENCE: (For sponsored candidates attach relevant certificate)

Name and address of the employer From To Designation Last Salary Drawn

INSTRUCTIONS TO FILL THE FORM:

All required details should be carefully and correctly filled up by the candidate.

All information should be in CAPITAL LETTERS and Black Ink only.

Application should be supported by attested true photocopies of marksheets and certificate as mentioned below.

DECLARATION BY THE CANDIDATE

The particulars furnished by me are true and correct

Date Place Name & signature of student