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Application No. 2021123728: Application Form For B.Tech. Admissions - 2021

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VISHAGAN M

The document is an application form for admission to a B.Tech program in 2021. It contains information such as the candidate's name, date of birth, gender, community, subjects, contact details, parent details, address, school name and board, and a declaration signed by the candidate agreeing to the terms.

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Application No. 2021123728: Application Form For B.Tech. Admissions - 2021

Uploaded by

VISHAGAN M
21 views2 pages
The document is an application form for admission to a B.Tech program in 2021. It contains information such as the candidate's name, date of birth, gender, community, subjects, contact details, parent details, address, school name and board, and a declaration signed by the candidate agreeing to the terms.

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2021123728 (1)

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The document is an application form for admission to a B.Tech program in 2021. It contains information such as the candidate's name, date of birth, gender, community, subjects, contact details, parent details, address, school name and board, and a declaration signed by the candidate agreeing to the terms.

Copyright:

© All Rights Reserved
Download as PDF, TXT or read online from Scribd
Download as pdf or txt
21 views2 pages

Application No. 2021123728: Application Form For B.Tech. Admissions - 2021

Uploaded by

VISHAGAN M
The document is an application form for admission to a B.Tech program in 2021. It contains information such as the candidate's name, date of birth, gender, community, subjects, contact details, parent details, address, school name and board, and a declaration signed by the candidate agreeing to the terms.

Copyright:

© All Rights Reserved
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Application form for B.Tech.

Admissions - 2021

Application No.

2021123728
Candidate Name : JAWAHAR M
Date of Birth 25-12-2003 Gender MALE

Community OBC / BC Native State TAMIL NADU

EWS Status No Subjects Appearing MPCEA

Mobile No. 9489335377 Email ID. [email protected]

Residential Status Indian Test city Salem

Qualifying Exam 12th Class Month & Year MAY - 2021


passing/appearing

Parent name MARAN C Parent mobile number 9489335377

Address for correspondance 7/648, GOVINDASAMY NAGAR, HARUR, DHARMAPURI, DHARMAPURI,


TAMIL NADU - 636903

Name of the Board CENTRAL BOARD OF SECONDARY EDUCATION


Name of the School SENTHIL PUBLIC SCHOOL
DECLARATION
I solemnly and sincerely affirm that I am Indian National / PIO/OCI holder and that all particulars furnished by me in this application form are true and correct. I
have not concealed any information. However, in the event of any information being found to be incorrect, fraudulent or untrue, either before or after the
examination or after my admission to the programme, I understand that I am liable to face criminal prosecution and the management can claim all authority to
cancel my candidature / selection or admission as the case may be and I would have to forgo my seat and the fees.I will pay the required Tuition fees and the
Hostel fees within the stipulated time to ensure my admission in VIT. I agree to abide by the rules and regulations governing the examination as well as the rules
pertaining to the refund of Tuition and Hostel fees. I further undertake to submit all the required certificates as per the rule, either at the time of counselling or
during the admission process, failing which I understand that I would have to forego my seat and the fees. I have read the brochure and understood the contents
in general and the method of Equipercentile Equating in particular. I accept this method to be adopted for Merit List preparation by VIT.I understand that all
information related to VIT application form and VIT exam will be only sent through the valid mobile number/email as provided by me in the same form and
consent to receive alerts / information by VIT through my mobile / email / connected social media platform. I am also aware that the application cost and the
Counselling Processing Fee are non-refundable

Signature of the candidate


Payment Acknowledgment Copy

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