Application for Admission to 4 Years (8 Semesters) B.E. Degree Course in Engineering for the year 2006 – 2007.
1. Name of the Candidate (in block letters)
6. Annual Income of Parents/Guardian (if parent is not alive)
7. Last College/School attended
a) Date of leaving the Institution
b) Highest Examination passed
a)
b)
1. Karnataka
2. Non-Karnataka -
3. N.R.I. -
10. Branch of Engineering which the Applicant prefers to select (please tick)
1 . Civil Engg.
2. Mechanical Engg.
3 . Electrical & Electronics Engg.
4. Electronics & Commn. Engg
5. Comp.Science & Engg.
Examn.
Name of University /Board
No. of attempts to pass the Exam
Year of Passing
Total Marks secured
a) P.U.C./ Inter
b) Diploma (3 yrs)
c) Other Examn. If any
Marks in optional Subjects
a) Physics
b) Maths
c) Chem.
Year
Class
Institution
Remarks
1.
12 th
2.
11 th
3.
10 th
4.
9 th
5.
8 th
Are the following attested copies of certificate enclosed ?
Matriculation Marks Card (10 th Std) Qualifying examination marks card (12 th Std) Transfer Certificate / College leaving certificate / Discharge Certificate Medical Fitness Certificate from Doctor's registered with Medical Councils of any state. Copy of Admission ticket / result sheet of KRLMPCA / AIEEE / Comed-K / Karnataka CET (if any).
