S N M POLYTECHNIC MOODBIDRI
REGISTRATION FOR FINAL YEAR STUDENTS OF S N M POLYTECHNIC 2016-2017
NOTE: ITI STUDENTS CAN IGNORE 1ST AND 2ND SEMESTER MARKS ENTRY
NAME OF THE STUDENT
Enter the full name as in SSLC Marks card in capital letter
Your answer
FATHER'S NAME
Your answer
GENDER
REGISTER NUMBER
Enter in capital letter
Your answer
BRANCH
ITI/JOC
CONTACT NUMBER
Your answer
EMAIL-ID
Your answer
RELIGION
Your answer
NAME OF CASTE (WITH CATEGORY)
Your answer
DATE OF BIRTH(D-M-Y)
MM
/
DD
/
YYYY
AGE
Your answer
MARKS IN X
PLEASE WRITE THE MARKS IN PERCENTAGE Eg: 60%
Your answer
MARKS IN XII
PLEASE WRITE THE MARKS IN PERCENTAGE Eg: 60%
Your answer
I 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
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 / AWARDS
Your answer
CONTACT ADDRESS
Your answer
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