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Online Registration form for Engg Admissions under Management Quota for the academic year 2012-2013



1. Full Name *
 :
2. Date of birth * :
Date Month Year
3. Gender *   :      
4. Religion * :
5. Community(Only for Karnataka Students) :
6. Mother Tongue * :
7. Address for Correspondance * :
City * :
State * :
Country : India
Postal Code :  
Phone No. with Country Code
Mobile No. * :
Phone No. :
Email ID * :
Confirm Email ID * :
8. Name of the Parent/Guardian * :
8(a). Relationship with the Candidate *
8(b). Contact number of the Parent/Guardian
9. Parent's/Guardian's Occupation* :
Qualifying Examination Details
10. 10thstd. % * : %  
11. PUC/XII std. Reg Number. * :
12. Qualifying Examination (PUC/XII std.) : Appeared
Marks Obtained in PUC/XII std.* (All marks should be filled in % only)
       
Physics in % Chemistry in % Maths in % Other subjects in %
13. Month and Year of passing/passed in +2 * :
14. Medium of Instruction * :
Other Details
15. No. of Entrance Exams Appeared :
               
                  
16. Course(s) of Your Choice * :
Ist Preference IInd Preference IIIrd Preference
17. Where did you see our Admission Advertisement ? * :
18. Whether hostel facility required * :