Application Form for Admission of Foreign Students under Exchange Programmes in to
INDIAN INSTITUTE OF TECHNOLOGY GUWAHATI
(only for the students of institutes/universities having student exchange programme with IIT Guwahati)

1.(a) Name (in block letters): Mr/Ms............................................................………	

   (b) Father/Husband/Guardian ...........................................................................            

   (c) Addresses: 
 	Affix passport size Photograph	
i) For correspondence                                                     ii) Permanent
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 Email: 				     	Phone:		                             	Fax:	
2. (a) Date of Birth : date …… month ……….year……..   (c) Marital Status
   (b) Nationality   		             		
         (attach photocopy of Passport) 		             	
3. (a)  Programme to which the candidate seeks temporary admission in IIT Guwahati ( Tick  ): 
 Bachelor of Technology (BTech)         Bachelor of Design (BDes)          Master of Science (MSc)
 Master of Technology (MTech)            Doctor of Philosophy (PhD)      
    (b)  Department/Centre to which the candidate seeks admission 
    (c)   Project/research area 	
    (d)   Proposed supervisor in IIT Guwahati
     (d)  Proposed duration of stay at IIT Guwahati:            months (from                             to                             )	
4. Parent University/Institute of the applicant:
(a) Name of the University/Institute
(b) Address of the University/Institute
(c) Department                                                                       (d) Ongoing Academic Programme
(e) Total duration of the programme                                      (f)  Semester/Term completed
(g) Latest Cumulative Grade Point Average / Cumulative Performance Index    ____ out of maximum ___ 

Signature of the student                                                              Date	
 5. Recommendation from the supervisor in the parent University/Institute :
     Name                                                                           Designation
     Telephone No.                                     Fax No.                                             email id
     
     Signature                                                                       Date	
 6. Forwarding by the official coordinating the exchange programme in the parent University/Institute:
   Name                                                                            Designation
   Telephone No.                                     Fax No.                                             email id

      Signature                                                                      Date