Application Form Please enable JavaScript in your browser to complete this form.Name *FirstLastDate of Birth *Gender *SelectSelectMaleFemaleOthersNationality *Community *SelectSC/STBCMBCOCOthersReligion *SelectHinduMuslimChristianOthersCast *Mobile NoEmail *Aadhar No *Blood GroupSelectO+B+A+AB+A-B-AB-Quota *SelectGovernmentManagementSelect the course that you want *SelectB.E Computer Science and EngineeringB.TECH Information TechnologyB.E Mechanical EngineeringB.E Civil EngineeringB.E Electrical and Electronics EngineeringB.E Electronics and Communication EngineeringM.E Computer Science and EngineeringM.E Manufacturing TechnologyM.E Power Electronics and DrivesM.E Structural EngineeringHSC +2 DetailsHSC Register No *+2 Marks Obtained *Month and Year of Passing *Board *Medium *Name of the School *Place of the School *Type of SchoolPrivateGovernmentOthersQualified State *Qualified City *Group Name *Family DetailsFather Name *Qualification *Occupation *Designation *Annual Income *Father's Mobile No *Email *Mother Name *QualificationOccupationDesignationMother's Annual IncomeMobile NoEmail *AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeIs Single Parent? *YesNoAre you an Non-Resident Indian(NRI)? *YesNoIs Hostel Accommodation Required? *YesNoIs Transport Required? *YesNoIs Physically Challenged? *YesNoDeclaration *I do hereby declare that above particulars of information and facts stated are true, correct and complete to the best of my knowledge and beliefSubmit Your Registration Form
