(Approved by AICTE & Affiliated to Visvesvaraya Technological University) K.R.ROAD, V.V.

PURA, BANGALORE-560 004

APPLICATION FORM FOR ADMISSION TO I SEM. B.E. DEGREE COURSE FOR THE YEAR 2011-12

PHOTO

Application No:

COMEDK /CET Reg.No:

COMED-K/CET Rank:
(Attach Xerox copy)

Branch sought for (give in order of preference) 1. 2. 3. 4. 5. 6.

CANDIDATES PERSONAL DETAILS 1. Name of the Candidate (Block Letters) 2. Age & D.O.B : :

3. Father/Guardian Name : Mother Name : 4. Occupation of Father/Mother/Guardian : 5. Permanent Address: Postal Address:

-Residence: Office: 6. Annual Income of parents from all sources: Rs. 7. Mother Tongue:
10. Nationality:

e.mail: 9. State:
12. Caste: 13. Blood Group:

8. Native Place:
11. Religion:

14. Name of the qualifying Examination: a) Name and Address of the College last studied b) Board of Examination c) Reg.No. in the qualifying Examn. d) Year of Passing e) Total Marks & percentage obtained f) Marks and Percentage obtained in PCM group: g) % in Physics: PLACE: Date: h) % in Chemistry:

Marks: i) % in Maths:

%:

Signature of Parent/Guardian FOR OFFICE USE ONLY

Signature of Candidate

Admit Mr/Ms.to I Sem.B.E for the academic yearFee remitted Rs.. Vide Receipt/Challan No: dated. Towards fee for.
CASHIER SUPTD. ADMISSIONS PRINCIPAL BIT

(Approved by AICTE & Affiliated to Visvesvaraya Technological University) K.R.ROAD, V.V.PURA, BANGALORE-560 004
APPLICATION FORM FOR ADMISSION TO M.B.A. COURSE FOR THE YEAR 2011-12

PHOTO

Appl.No: Whether appeared for KMAT/PGCET or any other National level eligibility Test, Specify Category (tick ): GM PH Def. Sports Group (tick ): IA, IB, IIA, Reg.No: Rank: ST IIIB

NCC IIB,

SC IIIA,

CANDIDATE PERSONAL DETAILS 1. Name of the Candidate (Block Letters) : 2. Age & D.O.B : 3. Father/Guardian Name : Mother Name : Postal Address:

4. Permanent Address:

-Residence: Office: : 5. Occupation of Father/Mother/Guardian : 6. Annual Income of parents from all sources: Rs. 7. Mother Tongue:
10. Nationality:

e-mail:

8. Native Place:
11. Religion: 12. Caste:

9. State:
13. Blood Group:

14. Name of the qualifying Exam: a) Name and Address of the College last studied b) Board of Examination c) Total Marks & % aggregate marks obtained in all 3years of the Degree course d) Reg. No. in the qualifying Exam. 15. Marks Card / TC/ Certificates Etc., Xerox Copies (Mark
SSLC-MC PUC-MC Degree-MC Migration Study

e) Year of Passing: whichever applicable)

TC Caste Eligibility

* Eligibility requirement as per VTU regulations. (see website www.vtu.ac.in) PLACE: Date:

Signature of Parent/Guardian

Signature of Candidate

FOR OFFICE USE ONLY

Admit Mr/Ms.to I Sem. MBA .... for the academic yearfee remitted Rs..Vide Receipt/Chelan No: dated. Towards fee for.
CASHIER SUPTD. ADMISSIONS PRINCIPAL BIT

(Approved by AICTE & Affiliated to Visvesvaraya Technological University) K.R.ROAD, V.V.PURA, BANGALORE-560 004
APPLICATION FORM FOR ADMISSION TO M.C.A. COURSE FOR THE YEAR 2011-12

PHOTO

Appl.No:
Whether appeared for any state level or any other National level eligibility Test, Specify

Category (tick Group (tick ):

): IA,

GM IB,

PH

Def. IIA,

Sports

NCC IIB,

SC IIIA,

Reg.No: Rank: ST IIIB

CANDIDATES PERSONAL DETAILS 1. Name of the Candidate (Block Letters) : 2. Age & D.O.B : 3. Father/Guardian Name : Mother Name : Postal Address:

4. Permanent Address:

-Residence: Office: : 5. Occupation of Father/Mother/Guardian : 6. Annual Income of parents from all sources: Rs. 7. Mother Tongue:
10. Nationality:

e.mail:

8. Native Place:
11. Religion: 12. Caste:

9. State:
13. Blood Group:

14. Name of the qualifying Exam: a) Name and Address of the College last studied b) Board of Examination c) Total marks & % aggregate marks
obtained in all 3years of the degree course

d) Reg. No. in the qualifying Exam. 15. Marks Card / TC/ Certificates Etc., Xerox Copies (Mark
SSLC-MC PUC-MC Degree-MC Migration Study

e) Year of Passing: whichever applicable)

TC Caste Eligibility

* Eligibility requirement as per VTU regulations. (see website www.vtu.ac.in)

PLACE:

Date:

Signature of Parent/Guardian

Signature of Candidate

FOR OFFICE USE ONLY

Admit Mr/Ms.to I Sem.MCA for the academic yearFee remitted Rs.. Vide Receipt/Challan No: dated. Towards fee for.
SUPTD. ADMISSIONS PRINCIPAL BIT

CASHIER