Malla Reddy College of Engineering for Women-MAISAMMAGUDA

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:

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 % :