Application Form

Full Name (as per SSLC Certificate) *

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Email *

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Date of Birth (as per Birth Certificate) *

Please provide a valid date of birth.

Religion *

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Caste *

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Nationality *

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Gender

Male

Female

Father's Name *

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Mother's Name *

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Permanent Address *

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Communication Address *

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

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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.
Biomedical & Robotic Engineering	Please select a preference.
Artificial Intelligence & Machine Learning	Please select a preference.

Common Entrance Test (KEAM 2025/KEE 2024/JEE 2024)

Exam	Score 1	Score 2	Total

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 Board *

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
Physics	Provide a valid mark	Provide a valid mark	Provide a valid mark
Mathematics	Provide a valid mark	Provide a valid mark	Provide a valid mark
Chemistry/Equivalent	Provide a valid mark	Provide a valid mark	Provide a valid mark
Total

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.