College Code : 899
Online Admission
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ADMISSION ENQUIRY FORM
Academic Year (2024-25)
Student Name
*
:
Date of Birth
*
:
Age
*
:
Gender
*
:
Male
Female
Religion
*
:
Hindu
Muslim
Christian
Others
Caste
*
:
Community
*
:
SC
ST
BC
MBC
OC
DNC
Others
Admission sought for classes
*
:
Civil Engineering
Mechanical Engineering
Electrical & Electronics Engineering
Electronics & Communication Engineering
Computer Engineering
Education Qualification
*
:
SSLC
HSC/ITI
1. Name of the School / College
2. Register Number
3. Marks Obtained
4. Year of Passing
5. Group Name
-
Physically Challenged
*
:
Yes
No
Place
*
:
District
*
:
Name of the Father
*
:
Father's Occupation
*
:
Father's Monthly Income (For statistical purpose only)
*
:
Name of the Mother
*
:
Mother's Occupation
*
:
Mother's Monthly Income (For statistical purpose only) :
Name of Brother/Sister if any studying in this college :
Name
Relationship
Course Studying
1.
2.
3.
Permanent Address
*
:
Temporary Address
*
:
Phone No. :
Mobile No.
*
:
Alternative Mobile No. :
E-mail
*
:
Referred by :