APPLICATION NO :

APPLICATION FORM
All * fields are mandatory
ENGINEERING ENTRANCE COMPETITIVE EXAMINATION (LATERAL ENTRY)-2020



*APPLICANT'S NAME:

(Name as recorded in the Matriculation/Secondary Examination Certificate.
Do not use Mr./Shri/Dr etc.)



*FATHER’S /GUARDIAN’S NAME


(Father Name as recorded in the Matriculation/Secondary Examination Certificate. Do not use Mr./Shri/Dr etc.)



*MOTHER'S NAME


(Please do not use any prefix such as Smt./Mrs. etc.)



*DATE OF BIRTH


(DOB should be same as in 10th Certificate)



*GENDER



*RESIDENTIAL STATUS



*CATEGORY






*DO YOU WANT TO AVAIL FOR TUTION FEE WAIVER (TFW) SCHEME



*PERSON WITH DISABILITIES (PWD)







*ANNUAL FAMILY INCOME




*NATIONALITY



*AADHAAR NUMBER



*APPLY FOR


*1ST CHOICE OF EXAM CITY



*EMAIL ID



*MOBILE NUMBER