Application

APPLICATION FOR ADMISSION TO B.TECH (LATERAL ENTRY) DEGREE COURSE 2024 - 2025

Name of the Candidate (In block letters) *

Email *

Mobile *

Photo *

Date of Birth *

Age *

Gender *

Nationality *

Religion *

Community *

Category *

Blood Group *

Aadhar Number *

Permanent address is same as address for communication

Permanent Address *

Address For Communication

Signature of the Applicant *

Place *

Fathers Name *

Fathers Occupation *

Fathers Mobile No

Mother's Name *

Mother's Occupation *

Mother's Mobile No

Annual Family Income *

Guardian's Name

Relation with Guardian

Guardian's Mobile No

Signature of the Parent *

Name of the Institution last studied (Diploma)*

Month & Year of passing *

Diploma mark *

Diploma Percentage *

Plus2 Percentage

SSLC Percentage *

Diploma Mark List *

Plus 2 Mark List

SSLC Mark List *

Course Preference 1 *

Declaration

We, the applicant & parent / guardian do hereby declare that all the information furnished above are true and correct and we will obey the rules and regulations of the institution, if admitted. Also we understand that the admission shall be, subject to satisfying the eligibility norms prescribed by the Statutory Authorities and the state Govt. from time to time.

I agree