Online Registration Form

  Name * :
  Father's Name* :
  Date of Birth* : Day
Month
Year
Category: GEN OBC SC ST NRI
  Correspondence Address* :
  Contact Phone Number : (R)
xxxx-xxxxxxx
(M)
xxxxxxxxxx
  E-mail ID :
   
  Father's Occupation : Business Service Self employed

  Father's Annual Income Range: : 0-1 Lacs. 1-2 Lacs. Above 2 Lacs.


  Course Applied : B.Tech    B.Tech Lateral Entry        M.Tech.(CE,EE,ME)       Polytechnic(CE,ME,EE) Polytechnic Lateral Entry B.Sc.

Choice 1st 2nd 3rd

MBA    MCA     MCA Lateral Entry


 
  Academic Record :
High School : Year Marks% CGPA
Intermediate: : Year Marks% PCM% Maths%
Poly. Diploma: : Year Marks% Branch
: Year Marks%
B.Tech: : Year Marks%
M.A/M.Sc. / M.Tech: : Year Marks%
Other : Year Marks%
   

  Competition Rank :
JEEP/JEE/AIEEE Roll No. All India Rank Uttarakhand Rank
UKSEE/UTUPGEE Roll No. Rank
Course (B.Tech 2nd Yr.)/MCA/MBA          
MAT Score. Month of Exam
CAT Score. Month of Exam
   

  Hostel Requirement: : Yes No

  Transport Requirement: Yes No
  Reference:  
  Name & Address : Phone:
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