B. Tech ADMISSION APPLICATION FORM for the A.Y. 2023-2024

Course :
Branch :  
Name of the Student(as per SSC):  
Father Name :  
Mother Name :  
Date Of Birth :  
Contact No 1 :    
Contact No 2 :  
E-Mail ID :    
H.No./Area :  
Village/Town :
Mandal :  
District :  
PinCode :    
State :  
Caste :  
Relegion:
Sub-Caste :
Mother Tongue:

QUALIFYING EXAMINATION DETAILS:

SSC Hall Ticket No. :  
SSC School Name :  
SSC Year of PASS : 
SSC Result %:  
Intermediate Hall Ticket No. : 
Intermediate College Name : 
Intermediate Year of PASS : 
Inetrmediate Result % : 


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