Application Form

Full Name *

Please provide a valid full name.

Email *

Please provide a valid email.

Date of Birth *

Please provide a valid date of birth.

Religion *

Please provide a valid religion.

Caste *

Please provide a valid caste.

Nationality *

Please provide a valid nationality.

Gender

Male

Female

Father's Name *

Please provide a valid father's name.

Mother's Name *

Please provide a valid mother's name.

Permanent Address *

Please provide a valid permanent address.

Communication Address *

Please provide a valid communication address.

Mobile Number (Enter a valid 10 digit mobile number) *

Please provide a valid contact number.

Quota *

Please select a quota.

Order of Preference for your courses *

Course Name	Preference
Civil Engineering	Please select a preference.
Mechanical Engineering	Please select a preference.
Electrical & Electronics Engineering	Please select a preference.
Electronics & Communication Engineering	Please select a preference.
Computer Science & Engineering	Please select a preference.

Name & Address of the Institute studied previously *

Please provide a valid name and address.

Details of the Qualifying Examination

Registration Number *

Please provide a valid registration number.

Year of course completion *

Please provide a valid year of completion.

Name of Exam *

Please select a valid board of examination.

Name of Examination *

Please provide a valid name of examination

Mark details of the Board examination *

Subject	Marks Secured	Max Marks	Percentage of Marks
SSLC	Provide a valid mark	Provide a valid mark	Provide a valid mark
Plus Two	Provide a valid mark	Provide a valid mark	Provide a valid mark
Diploma/Equivalent	Provide a valid mark	Provide a valid mark	Provide a valid mark

Please upload your latest Photo

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Please upload your Signature

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I hereby solemnly affirm and state that the details and information furnished in the application above and also in all the enclosures there to submitted are true and correct. I declare that I will, if admitted, abide by the stipulations in the prospectus, and the rules and regulations of the college.

Lateral Entry