APPLICATION FORM FOR ADMISSION TO B.TECH, PROGRAMME 2019-2020

Personal Details

Name of the Applicant as in SSLC Book*

Sex*

Religion*

Caste

Category

Aadhaar No.

Date of Birth*

Correspondence Address*

Permanent Address*

If permanent address same?

Mobile

Annual Family Income

Blood Group

Admission Quota*

Parents Details

Father's Name*

Occupation

Mobile*

Mother's Name*

Occupation

Mobile*

Academic Details
Details of Entrance Test

Entrance Type

Entrance Status

Year

Roll Number

Rank

Score

Physics + Chemistry Mark

Mathematics Mark

Total Mark

Details of Qualifying Examination (plus Two)

Mark Obtained

Percentage

Board

Branch Preference

1st Preference*

2nd Preference*

3rd Preference*

4th Preference*

5th Preference*

Certified that the information furnished above by me is true and correct to the best of my knowledge and belief

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