S N M POLYTECHNIC MOODBIDRI
REGISTRATION FOR FINAL YEAR STUDENTS OF S N M POLYTECHNIC 2018-19
NOTE: ITI STUDENTS CAN IGNORE 1ST AND 2ND SEMESTER MARKS ENTRY
Email address *
NAME OF THE STUDENT
Your answer
FATHER NAME
Your answer
GENDER
REGISTER NUMBER *
ENTER IN CAPITAL LETTERS
Your answer
BRANCH
ITI/JOC
MENTION THE COURSE
Your answer
CONTACT NUMBER *
Your answer
RELIGION
Your answer
NAME OF CASTE (WITH CATEGORY)
Your answer
DATE OF BIRTH(M-D-Y)
MM
/
DD
/
YYYY
AGE
ENTER COMPLETED YEARS AS PER DATE OF BIRTH
Your answer
MARKS IN X STD/SSLC/CBSE IN %
ENTER THE MARKS IN PERCENTAGE Eg: 60%
Your answer
MARKS IN XII STD/PUC IN %
ENTER THE MARKS IN PERCENTAGE Eg: 60%
Your answer
I SEM DIPLOMA MARKS %
ENTER THE MARKS IN PERCENTAGE Eg: 60%
Your answer
PENDING SUBJECTS(ignore if not applicable)
ENTER THE NUMBER OF SUBJECTS PENDING
II SEM DIPLOMA MARKS %
PLEASE WRITE THE MARKS IN PERCENTAGE Eg: 60%
Your answer
PENDING SUBJECTS(ignore if not applicable)
ENTER THE NUMBER OF SUBJECTS PENDING
III SEM DIPLOMA MARKS %
PLEASE WRITE THE MARKS IN PERCENTAGE Eg: 60%
Your answer
PENDING SUBJECTS(ignore if not applicable)
ENTER THE NUMBER OF SUBJECTS PENDING
IV SEM DIPLOMA MARKS %
PLEASE WRITE THE MARKS IN PERCENTAGE Eg: 60%
Your answer
PENDING SUBJECTS(ignore if not applicable)
ENTER THE NUMBER OF SUBJECTS PENDING
V SEM DIPLOMA MARKS %
PLEASE WRITE THE MARKS IN PERCENTAGE Eg: 60%
Your answer
PENDING SUBJECTS(ignore if not applicable)
ENTER THE NUMBER OF SUBJECTS PENDING
VI SEM DIPLOMA MARKS %
PLEASE WRITE THE MARKS IN PERCENTAGE Eg: 60%
Your answer
AGGREGATE
PLEASE WRITE THE MARKS IN PERCENTAGE Eg: 60%
Your answer
ITI AGGREGATE %
THIS OPTION IS ONLY FOR ITI CANDIDATES
Your answer
OTHER ACTIVITIES / ACHIEVEMENTS /
Your answer
CONTACT ADDRESS
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of SNM Polytechnic. Report Abuse - Terms of Service - Additional Terms