Jain College of Engineering &Technology,Hubballi
ADMISSIONS 2019-20
INSTRUCTIONS
1) Forms need to be filled by students only.
2) The fields with the' * ' are mandat
Candidate Name:(As per SSLC/SSC Marks Card) *
This is a required question
Your answer
Father Name:(As per SSLC/SSC Marks Card) *
Your answer
Mother Name *
Your answer
Gender: *
Date of Birth *
MM
/
DD
/
YYYY
Blood Group *
Nationality *
Your answer
Religion *
Your answer
Caste *
Your answer
Category *
Student Contact Number: *
Your answer
Parent's Contact Number *
Your answer
E- Mail ID(Student) *
Your answer
E- Mail ID(Parents)
Your answer
Parmanent Address : *
Your answer
Correspondence Address : *
Your answer
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