ONLINE APPLICATION FORM FOR B-TECH
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Name of the Student :
Name of the Father/Guardian :
Address :
Tel no. :
Mobile no. :
E-mail :
Contact no. in case of Emergency :
Overseas Address(if parent employed overseas) :
Branch Preference
1st Preference :
2nd Preference :
3rd Preference :
Marks obtained for subjects in 10th standard
Name of School-10th Std :
Total Marks :
Physics :
Chemistry :
Maths :
Board of Education :
Marks obtained for subjects in 12th standard
Name of School-12th Std :
Total Marks :
Physics :
Chemistry :
Maths :
Board of Education :
Entrance Examination Marks (Kerala) :   (if any)
Entrance Examination Marks (All India) :   (if any)
Entrance Examination Rank (Kerala) :   (if any)
Entrance Examination Rank (All India) :   (if any)
Other Extra curricular activities :

Outstanding achievements :