• Course Details
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Regular/Lateral : Regular Lateral
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:
Personnel Information
:
Date of Birth :
Age :
Gender : Male Female
Blood Group :
Mother Tongue :
Religion :
Community :
Caste :
Physically Handicapped ? : Yes No
Reserved Category :
Parent/Guardian Details
Father's Name :
Father's Occupation :
Father's Income :
Mother's Name :
Mother's Occupation :
Mother's Income :
Guardian's Name :
Guardian's Occupation :
Guardian's Income :
Nationality :
Native Place :
Civic Status of Native Place :
State :
Mobile Number     :
Email Id :
Communication Address
Address Line 1 :
Address Line 2 :
City :
Pin Code :
Res Phone Number :
Permanent Address
Address Line 1 :
Address Line 2 :
City :
Pin Code :
Res Phone Number :
Permanent Address Same as Communication Address? Yes No
Whether availing First Graduate Concession. If yes, certificate from Revenue Department is to be enclosed (Goverment Quota Candidates only) : Yes No
Transfer Details
(i) T.C. No :
(ii) T.C Date :
Qualifying Examination :
Medium Of Instruction :
Academic details of (X Std & HSC / Equivalent)
Class Year of Passing % of Marks Class Name of the School / Polytechnic
X Std. / Matric
XII Std. / Intermediate
Diploma
HSC (Academic or Equivalent)
Name Of Board    :
Register Number   :  
Subjects Month and Year of Passing Marks Obtained Maximum Marks Percentage
Language
English
Physics
Chemistry
Mathematics
Eligible Percentage (Maths + Chemistry + Physics) =
HSC (Vocational)
Name Of Board    :
Register Number   :  
Subjects Month and Year of Passing Marks Obtained Maximum Marks Percentage
Language
English
Related Subject
Theory
Practical I
Practical II
Eligible Percentage (Related Subject + Vocational) =
Bachelor's Degree (For Lateral Entry)
Qualifying Degree Passed      :
Major Subjects of the Degree   :
Name Of University         :
Register Number             :  
Semester Month and Year of Passing Marks Obtained Maximum Marks Percentage
I
II
III
IV
V
VI
Eligible Percentage =
Diploma in Engineering / Technology (For Lateral Entry)
Name of Polytechnic / Board    :
Register Number          :  
Semester Month and Year of Passing Marks Obtained Maximum Marks Percentage
I
II
Eligible Percentage (PreFinal Semester + Final Semester) =