Vijnan Institute of Science and Technology
APPLICATION FOR ADMISSION TO THE B.TECH DEGREE COURSES
QUOTA *
1. Candidate's Name(In capital 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. Blood Group
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5. Nationality *
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6. Religion *
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7. Caste *
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8. Category *
9. 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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Candidates Mobile Number
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10. Father's Name *
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Occupation *
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Father's Mobile No *
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11. Mother's Name *
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Occupation
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Mother's Mobile No
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12. Annual Income *
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13. Name and Place of school attended for 12th *
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14. Qualifying Examination Passed *
14.a) Month and Year *
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14.b) Register No *
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15. 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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