Permanent Address

Present Address(Should inform to principal if changed)

Guardian Details (If parents are not alive)

Educational Qualification of Parents (If nothing, enter "none")

Details Of Marks in Qualifying Examination

To be filled by Candidate Passing 10+2

Subject	Marks Secured	Maximum Marks	Percentage(%) Of Marks Scored (Upto 2 Decimal Points)
Physics
Mathematics
Any One of the following Chemistry, Biology, Bio-Technology Computer Science, Electronics

To be filled by Diploma Candidate

	Marks Obtained in Diploma IIIrdYear	Max.Marks of Diploma IIIrdYear	Percentage Aggregate Of Marks Scored
Total

Branch of Engineering Desired in order of Preference. (No Changes will be Permitted later at any Change)

Branch Codes

Automobile EngineeringAE

Civil EngineeringCVE

Computer Science and EngineeringCSE

Electronic and Communication EngineeringECE

Electrical and Electronics EngineeringEEE

Information Science and EngineeringISE

Mechanical EngineeringME