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Application 2010-11

Name of Candidate

Father’s Name

Mother’s Name

Date of Birth

Course Applied for

Following are the choices of my preference for admission in B. Tech course for the Academic Session 2010-2011.

Residence Address

Telephone No.

(R)		Mobile
Office

E-mail address

Father’s Occupation

Company Name
Designation

Mother’s Occupation

Merit Position

(i) U.P. SEE 2010

Category Rank

State Rank

(ii) AIEEE

All India Rank

State Rank

(iii) % of 10+2

(PCM)

(PCB)

(Over All)

(iv)% Graduation

For MBA, MCA

MAT/CAT Score

I am enclosing herewith self attested photocopies of following

(i) 10+2 Examination Mark sheet

(ii) UP State Entrance Examination Result.

(iii) AIEEE Result.

(iv) Graduation Mark sheet

(v) ID/Address Proof (DL /Voter ID Card

(vi) Income Tax PAN No.

Reference

(i)

(ii)

Whether Hostel required

Yes
No

I understand that

>> That admission to the College is based on merit and I will deposit the non-refundable fee and appear for interview/counseling before the Admission Committee.
>> That ragging is an illegal and punishable offence/act and I will not involve in any ragging activity in campus during my study tenure.
>> That once registration done no adjustment/refund of fee is permissible for any reason whatsoever. The fee is provisional subject to revision any time.

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