| Personal
Details |
| Name* |
Enter your Full Name.
|
Gender * |
Select the appropriate option. |
| Date of Birth * |
Select your date of birth from the date picker. |
| Blood Group |
Select your blood group from the drop down. |
| Category * |
Select your caste from the drop down. |
| Nationality * |
Select your nationality from the drop down. |
| Program * |
Select your program from the drop down. |
| B.Tech Preferences |
| Preference1 * |
Select your First Preference for B.Tech Program. |
| Preference2 * |
Select your Second Preference for for B.Tech Program. You are not allowed to select the same option as selected in Preference 1.
|
| Preference3 |
Select your Third Preference for B.Tech Program. You are not allowed to select the same option as selected in Preference
1 and Preference 2. |
| Upload Photo(Only .jpg or .jpeg or .gif formats, Upto 100 KB) |
| Upload Photo |
Upload your recent photograph. |
| Present
Address |
| Address Line 1 * |
Enter
your door number, apartment number in the address line 1 field. |
| Address Line 2 |
Enter your street address. |
| Address Line 3 |
Enter your locality name. |
| City * |
Enter the city where you are located at present. |
| State * |
Select
the state where you are located at present. |
Country * |
Enter the country name.
|
| Pincode * |
Enter your area pincode (Note:
Fill only numeric characters only (0-9). Do not leave spaces
in between). |
Phone Number (With STD Code) * |
Enter the STD code and phone number of your
city (For e.g. 0444234522). |
| Mobile Number * |
Enter your mobile number. |
Fax |
If you have any Fax number
please fill it in this column. |
| Primary Email * |
Please
enter the email address.For e.g. [email protected].
Do not use anyone else’s email address. |
Retype Primary Email * |
Please retype the Primary Email ID. |
| Alternate Email |
Please
enter the alternate email address. |
Retype Alternate Email |
Please retype the Alternate Email ID. |
| Is Permanent address same as
Present Address |
If the answer is YES, please
indicate. If the answer is NO, you will have to fill in your
permanent address in the fields that appear. |
| Family Details |
| Father Name * |
Specify the name of your Father. |
| Mother's Name * |
Specify the name of your Mother. |
| Qualification |
Mention the Qualification of your Father. |
| Mother's Qualification |
Mention the Qualification of your Mother. |
| Occupation |
Mention the occupation of your Father. |
| Mother's Occupation |
Mention the occupation of your Mother. |
| Organization |
Mention the organization of your Father. |
| Mother's Organization |
Mention the organization of your Mother. |
| Address* |
Mention the Address. |
| Parents Email ID |
Specify the email id of your Parent. |
| Mobile Number |
Specify the mobile number of your Parent. |
| Telephone-Residence(With STD Code) * |
Specify the residence telephone number of your Parent. |
| Telephone-Office(With STD Code) |
Specify the office telephone of your Parent. |
| Educational Details |
| X |
| School Name * |
Enter the name of the school you studied in. |
| Board / University Name * |
Specify the Board / University. |
| State * |
Enter the state. |
| Year of Passing * |
Select the year of passing from the drop down. |
| Percentage Scored * |
Enter your overall percentage. |
| XII |
| School Name |
Enter the name of the school you studied in. |
| Board / University Name |
Specify the Board / University. |
| State |
Enter the state. |
| Year of Passing * |
Mention the year in which you passed. |
| Percentage Scored |
Enter your overall percentage. |
| Main Subjects * |
Enter your major subjects. |
| UG Degree |
| Examination type * |
Select the relevant option. |
| Name of degree * |
Enter your degree. |
| College Name * |
Enter the college you studied in. |
| Board / University * |
Enter the Board or University. |
| State * |
Enter the state. |
| Year of Passing * |
Mention the year in which you passed. |
| Major Subject / Discipline * |
Enter your major subjects. |
| Mode of Study * |
Select the mode of study from the drop down provided. |
| Total Aggregate % * |
Enter your overall percentage. |
| If the examination type is Semester wise, fill in the following details |
| 1 Year/Sem 1 (%/CGPA)* |
Enter your 1st year 1st semester percentage. |
| 1 Year/Sem 2 (%/CGPA)* |
Enter your 1st year 2nd semester percentage. |
| 2 Year/Sem 3 (%/CGPA)* |
Enter your 2nd year 3rd semester percentage. |
| 2 Year/Sem 4 (%/CGPA)* |
Enter your 2nd year 4th semester percentage. |
| 3 Year/Sem 5 (%/CGPA) |
Enter your 3rd year 5th semester percentage. |
| 3 Year/Sem 6 (%/CGPA) |
Enter your 3rd year 6th semester percentage. |
| 4 Year/Sem 7 (%/CGPA) |
Enter your 4th year 7th semester percentage. |
| 4 Year/Sem 8 (%/CGPA) |
Enter your 4th year 8th semester percentage. |
| If the examination type is Year wise, fill in the following details |
| 1 Year (%/CGPA)* |
Enter your 1st year percentage. |
| 2nd Year (%/CGPA)* |
Enter your 2nd year percentage. |
| 3rd Year (%/CGPA) |
Enter your 3rd year percentage. |
| 4th year (%/CGPA) |
Enter your 4th year percentage. |
| Employment History |
| Do you have Work Experience * |
Select the relevant option from the dropdown. |
| Name of the Employer * |
Enter the name of organisation. |
| Address of Employer |
Enter the organisation address. |
| From Date * |
Select the date when you joined the organisation. |
| To Date * |
Select the date till you worked in the organisation. |
| Total experience in months * |
Specify your total experience in months. |
| Nature of work |
Specify the Nature of work. |
| Designation |
Mention your designation in the organisation. |
| Other Details |
| Hostel Accomadation |
| Do you need hostel Accomadation * |
Select the relevant option from the dropdown. |
| Merit Examination Scores (if any) (JEE (Main)/JEE (Advanced)/Karnataka CET/COMED-K/AUEET/Other State Entrances(please specify) |
| Exam Name1 |
Enter name of exam if any. |
| Date1 |
Enter the date of Exam1
here. |
| Registration Number1 (if any) |
Enter the Registration Number in Exam1. |
| Rank/Score Obtained1(if any(Attach copy of Rank Certificate)) |
Enter your Rank/Score Obtained in Exam1. |
| Exam Name2 |
Enter name of exam if any. |
| Date2 |
Enter the date of Exam2
here. |
| Registration Number2 (if any) |
Enter the Registration Number in Exam2. |
| Rank/Score Obtained2(if any(Attach copy of Rank Certificate)) |
Enter your Rank/Score Obtained in Exam2. |
| Exam Name3 |
Enter name of exam if any. |
| Date3 |
Enter the date of Exam3
here. |
| Registration Number3 (if any) |
Enter the Registration Number in Exam3. |
| Rank/Score Obtained3(if any(Attach copy of Rank Certificate)) |
Enter your Rank/Score Obtained in Exam3. |
| Exam Name4 |
Enter name of exam if any. |
| Date4 |
Enter the date of Exam4
here. |
| Registration Number4 (if any) |
Enter the Registration Number in Exam4. |
| Rank/Score Obtained4(if any(Attach copy of Rank Certificate)) |
Enter your Rank/Score Obtained in Exam4. |