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Please select where you want to take Admission * :

School College Engineering

Admission Type * :

New Admission Re-Admission

Application Form No (Use Bank Transaction ID as Number) * :

Bank Transaction Id :

Bank Transaction Amount :

Admission For The Class * :

MAT / UGAT Roll No :

MAT / UGAT Composite Score :

Name * :

Date of Birth * :

Sex * :

Male Female

Father's Name * :

Mother's Name * :

Father's Occupation * :

Nationality * :

Caste * :

Address for Correspondence * :

Pin Code * :

STD Code * :

Telephone No * :

Mobile No * :

Permanent Address * :

Pin Code * :

City * :

STD Code * :

Telephone No * :

Mobile No * :

E-Mail Id (Fill your correct E-Mail Id) * :

Education Qualification : - Course/Board, Institution, Year of Passing, AGGT % * :

Special Achievements / Awards Received * :

Working / Not Working (if working please specify company details & designation) * :

Refrees / Subjects * :

Hostel Required * :

Yes No

Bank Loan Required * :

Yes No

Date * :

Please Upload Scan Copy of the Bank Receipt :

Please upload your passport size Current Photo * :

Please Upload Scan copy of Class X Board Admit Card * :

Please Upload Board Marksheet or Pre Board Marksheet or Pre Class Marksheet. * :

Security Code * :

I accept all terms and conditions * :

Conditions :

• I declare that the information provided in this application form is true to best of my knowledge and belief.
• I have read and understood all the rules, regulations and disciplines of the Institute and agree to abide by them.
• I or any person on my behalf will not claim any refund money / fees paid to the Institute under any circumstances.