Student Information Form
Email address *
AKTU Roll No *
Your answer
Branch *
Student's Name *
Your answer
Father's Name *
Your answer
Mother's Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Category *
10th Board *
Your answer
10th % *
Your answer
10th Year of Passing *
Your answer
12th Board
Your answer
12th %
Your answer
12th Year of Passing
Your answer
Diploma Board
Your answer
Diploma %
Your answer
Diploma Year of Passing
Your answer
B.Tech I Semester % *
Your answer
B.Tech II Semester % *
Your answer
B.Tech III Semester % *
Your answer
B.Tech IV Semester % *
Your answer
B.Tech V Semester % *
Your answer
B.Tech VI Semester % *
Your answer
B.Tech Average % *
Your answer
Backlog History (No of COP) *
Your answer
Current Status of Backlog (No of COP) *
Your answer
Address for Correspondence (Current)
Your answer
Permanent Address *
Your answer
Mobile No (Personal) *
Your answer
Mobile No (Alternate) *
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 Buddha Institute of Technology. Report Abuse - Terms of Service