Application Form For Admission Under Category 'B'(Management Quota) Seats For The Year 2018-19 UG Courses: B.Tech. (EEE / ECE / CSE / ME / CIVIL)
Date:
Enter Your SSC Hall Ticket Number:
Course Details
Acadamic Year:	2018-19
Course:	B.Tech
Branch:	CSE ECE EEEMECH CIVIL
Personal Details
Name of the Candidate
Name of the Parent
Date of Birth
Gender	Male Female
Nationality
Religion
Country
State
City
Category	SC ST BC-A BC-B BC-C BC-D BC-E OC
Parent / Guardian Details
Parent / Guardian Name
Occupation
Annual Income
Address
Pincode
Telephone Number (with STD code)
Mobile Number
Email
Entrance Examination Details
CET Name	select cet name APEAMCET JEE-Mains
Appeared(Yes/No) year Hall Ticket No Rank Obtained YESNO
Educational Qualifications
Examination Year of pass Institution Board/University %of marks in aggregate % of marks in group class Inter(+2) CBSE ICSE OTHER STATE
Enclosures
Rank Card of JEE-Mains 2018/APEAMCET-2018
Hall Ticket of JEE-Mains 2018/APEAMCET-2018
Copy of SSC Pass Certificate as proof of Date of Birth:*
Copy of Marks Memo of Qualifying Examination (Intermediate or its equivalent):*
Passport Size Color Photograph :*
Demand Draft Scanned Copy(DD):*