B Tech Application 2023

Name of the applicant : *

Date of Birth *

Email Address *

Gender *

MaleFemaleOther

Religion *

Caste *

Permanent Address *

Communication Address *

Name of Father *

Occupation of Father *

Email id of Father *

Mobile no. of Father *

Name of Mother *

Occupation of Mother *

Email id of Mother *

Mobile no. of Mother *

Nationality *

Scheme of study for 10th standard *

Year of passing *

KEAM - 2023 DETAILS (IF APPLICABLE)

Appln Number

Rank

Paper I mark

Paper 2 mark

Total mark

Details of Qualification Examination *StateCBSEISCOthers

Name of Institution

Year of Passing

Total Marks

Percentage of Marks

SCHEME OF STUDY

Maths

Physics

Chemistry/Equivalent

1st year ( STATE ) -Max marks : 80

2nd year ( STATE ) - Max marks : 120

2nd year ( STATE ) : Max marks : 120

TOTAL ( STATE ) : Max marks : 200

Preferred Branch(CE, CSE, EEE, ECE, ME)

First Option

Second Option

Third Option

Fourth Option

Fifth Option

Anti Ragging undertaking reference number(www.antiragging.in)

Details of True Copies to Be Attached Along With the Application Form (Each file size up to 250Kb)

Please choose a JPG, JPEG, PNG file.

Admit card and Data Sheet issued by CEE

Certificate to prove Date of Birth

Orginal Mark List to prove academic eligibility(Plus Two)

Transfer certificate and Conduct certificate

Pass certificate (if obtained)

DECLARATION BY THE APPLICANT

I hereby solemnly declare that the details furnished are true. I also undertake that any wrong information furnished by me will forfeit my claim for admission. i will obey the rules and regulations of the institution, if admitted. I shall submit all certificates and documents in original at at the time of admission, failing which my admission will be liable for cancellation. I shall not resort to ragging in any form at any place and shal abide by the rules /laws prescribed by Courts,Governments, affiliating University and College authorities for the purpose from time to time.

College Code PAA