Approved by AICTE, New Delhi. Affiliated to Anna University, Chennai
 
Application Form For Admission To BE/BTech Degree Programmes By Lateral Entry 2011
1. FullName *
:
2. Date of birth * :
Date Month Year
3. Gender *   :      
4. Religion * :
5. Community * :
6. Mother Tongue * :
7. Address for Correspondance * :
City * :
State * :  (Mention only state)
Country * :
Postal Code * :  
Phone No. with Country Code
Mobile No. * :
Phone No. :
Email ID * :
Confirm Email ID * :
8. Name of the Parent/Gaurdian * :
9. Parent's/Gaurdian's Occupation * :
Qualifying Examination Details
10. 10th % with name of the School * :
Percentage School Name
11. Qualifying Examination (Polytechnic) * :
12. Reg Number in Polytechnic. * :
13. Name & address of the Polytechnic last studied * :
14. Department * :
15. Month and Year of passing/appearing * :
16. Marks Obtained (in %) * :
III Semester IV Semester
V Semester VI Semester
17. Medium of Instruction * :
18. XII Board * :