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    Shridevi Institute of Engineering & Technology (SIET ) Admission Application Form for Bachelor of Engineering [B.E]

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    Shridevi Institute of Engineering & Technology (SIET ) Admission Application Form for Bachelor of Engineering [B.E]

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    Shridevi Institute of Engineering & Technology (SIET ) Admission Application Form for Bachelor of Engineering [B.E]

    Copyright:

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    Download as PDF or read online from Scribd
    Download as pdf
    64 views2 pages

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    Uploaded by

    SIETDOC
    Shridevi Institute of Engineering & Technology (SIET ) Admission Application Form for Bachelor of Engineering [B.E]

    Copyright:

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    Download as PDF or read online from Scribd
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    SRI SHRIDEVI CHARITABLE TRUST (R)

    Shridevi Institute of
    Engineering & Technology
    Affiliated to Visveswaraya Technological University & Approved by AICTE,
    New Delhi Vide 06/06/KTK/ENGG/02/017 Dt. 27-05-2002
    S Sira Road,
    i r a R o a d , T U Tumkur-572106,
    M K U R - 5 7 2 1 0 6 . K Karnataka,
    A R N A T A K A , IIndia
    N D I A
    Ph.: 91-0816-2212629, 2212627, 2211066, 2211768, Fax : 0816-2212629,
    E-mail : [email protected], website : www.shridevieducation.org

    Branch: APPLICATION FORM No.

    Name :

    Name as entered in SSLC Affix


    Latest Passport Size
    Date of Birth Age Sex M F Photograph.
    Do not Staple / Pin
    the Photograph
    Nationality Religion Caste
    (Photograph not to be
    attested)
    Sub Caste Category SC ST OBC
    (If any)
    Father's /
    Guardian Name : (Signature of the Candidate)

    Occupation of Father / Guardian : Govt. / Private / Self Employed / Any others specify
    (If Parent is not alive)

    Job Details: Income. p.a

    Communication Address :

    Phone No. with STD Code : PIN

    Permanent Address :

    Phone No. with STD Code : PIN

    Details of Qualifying Examinations


    Name of the School / College last attended
    Highest Examination Passed
    Name of the University / Board last studied

    SUBJECT Max. Marks Min. Marks Marks Obtained


    1. English
    2. Regional Language
    3. Physics
    4. Chemistry/Biology/BT/CSE/EC/IS
    5. Mathematics
    Total of (3-5)
    Percentage of PCM
    Are the following copies of the certificates enclosed
    a) SSLC / SSC / Xth Std. YES / NO
    b) Marks card P.U. Course / Intermediate / YES / NO
    c) Transfer Certificate YES / NO
    d) Character & Conduct Certificate YES / NO
    e) Migration Certificate YES / NO
    f) Eligibility Certificate YES / NO
    Note : Originals of the above shall be produced at the time of admission without which the admission is not complete

    Extra Curricular Activities


    (Enclose Certificate Copies)

    COMEDK/CET/AIEEE No. COMEDK/CET/AIEEE Rank


    Admn. Order No. Category
    Date of Issue PUC / Inter. Reg. No.

    DECLARATION
    1. I do here by declare that the above information is correct.
    2. I promise to abide by the rules and regulations of the college / institution and to the subject to their disciplinary action
    and if needed, I may be removed from the college in case of persistent break of disciplinary rules.
    3. I understand original Certificates have to be submitted to Shridevi Institute of Engineering and Technology and these
    certificates will not be returned by Shridevi Institute of Engineering and Technology unless my full tuition fee is paid and
    all my dues are cleared.
    4. I understand all the information concerned on conducting the course will be communicated through verifications
    displayed on the college notice board and no individual communication will be sent.
    5. I shall not indulge myself in ragging in any form.
    6. If admitted to Shridevi Institute of Engineering and Technology, I agree to abide by the polices, rules, laws and
    regulations of the college as modified from time to time.
    7. I abide to maintain minimum 85% of Attendance, failing I may be detained for that semester.

    Date :
    Place :
    Signature of the Candidate

    DECLARATION BY THE PARENT / GUARDIAN


    I certify that the above particulars furnished by my son / daughter / ward are correct and I undertake for the good conduct
    and to educate my son / daughter / ward in your institute till the completion of the B.E. degree course. I shall be responsible
    for the payment of all his / her dues, if any to the Govt. of Karnataka / University / Institution.

    Date :
    Place :
    Signature of the Parent / Guardian

    FOR OFFICE USE ONLY


    Branch : ................................ Admission : ................................ No. : ................................
    Amount Paid in COMEDK/CET/AIEEE Rs. .............................................. Date ................................
    Amount Paid in SIET Rs. ................................................ Receipt No. ..................... Date ................................
    Admission : Granted / Rejected

    OFFICE SUPERINTENDENT PRINCIPAL

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