Online Registration Form

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Online Application Form

Name

Father;s Name

Date

Student's Mob No

Father's Mob No

Residential Phone no(if any)

Address1

Address2

City

State

Pin Code

Educational Qualification

Name of Examination	Board/University/Institute	Year of Passing	% Marks Obtained	Main Subjects
					×

(1)

Entrance Examination Details

JEECUP

Roll No.

General Rank

Category Rank

Rank

Declaration

I hereby declare that the information given by me in this form is correct to the best of my knowledge and belief. I have not concealed any fact or material information and I duly possess the minimum prescribed qualification. I understand that in case anything is found contradictory or false, my admission shall be cancelled. I shall abide by all terms, conditions, rules and regulations of the college/University/Government with regards to admissions.I have understood that my application will be considered only if any seat is available as per University/Govt. guidelines; otherwise this application will automatically be cancelled. The registration fee is not refundable in any case.

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