Application for Engineering College( BTECH ) for
Indian Students

Identity Of the Student
Student From* IndiaForeign
Application for Course*
Combination Proposed to be Taken
      Select Combination
Personal Information
Name (As per SSC) *
Father Name/Guardian Name*
Relationship with Guardian
Mother Name
Date Of Birth*
Gender* Male Female
Place Of Birth
Current Address*
     Street/ House No:*
     City*
     district*
     State*
     Pin Code*
     Phone No*
Permanent Address
     Street/ House No:
     City
     district
     State
     Pin Code
     Mobile No
     Phone No
     Email
Nationality
Religion
Mother Tongue
Category
Physically Handicaped
Ex-Servicemen
Other Reservations* Extra-Curricular
Games
NCC
NSS
Particulars of Qualifying Examination*
Name Of The Examination*
     Optional/Subject1
     Optional/Subject2
     Optional/Subject3
     Optional/Subject4
     Optional/Subject5
     One Attempt/Compartmental* One Attempt Compartmental
     Hall Ticket Number/ Reg. Number
     Month & Year of Passing
     Maximum Marks/Grade Points
     Marks/Grade Points Obtained
Particulars of Entrance Examination
(Qualifying in Entrance examination is not necessary for Management Seats)
     Entrance* Not Appeared Appeared Failed
     Entrance Appeared*
     EntranceMarks/GradeMarksObtained*
     Entrance Rank*
Photo*