Vijnan Institute of Science and Technology
APPLICATION FOR ADMISSION TO THE B.TECH DEGREE COURSES
QUOTA *
1. Candidate's Name(As in Xth certificate) *
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2. Gender *
3. Date of Birth *
MM
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DD
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YYYY
4. Nationality
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5. Religion
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6. Caste
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7. Category
8. Address for communication *
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Pin
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Taluk
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District
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Land Phone No(with STD Code)
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Contact Number *
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9. Father's Name
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Occupation
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Father's Mobile No
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10. Mother's Name
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Occupation
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Mother's Mobile No
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11. Annual Income
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12. Name and Place of school attended for 12th *
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13. Qualifying Examination Passed *
13.a) Month and Year *
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13.b) Register No
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14. Marks obtained in qualifying examination
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Mark Secured in Physics
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Maximum Mark
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Percentage of Marks
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Mark Secured in Chemistry
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Maximum Mark
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Percentage of Marks
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Mark Secured in Mathematics
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Maximum Mark
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Percentage of Marks
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15.a) State Entrance Test Roll No
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15.b) State Rank
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16. Marks obtained in the State Entrance Test
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* Paper - I (Physics + Chemistry)
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* Paper - II (Mathematics)
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17. Branch Preference *
18. Do you require Hostel Accommodation *
19. Do you require Educational Loan facility *
20. Do you require Bus facility *
If Yes;From where?
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Email *
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