Student Admission Form 2008-09
   
Roll No :- * Enter the number given on your ID card by college
Branch :- *
First Name :- *
Middle Name :-
Last Name :-
Sex :-
Date of Birth :- * [MM/DD/YYYY]
Date of Birth in words :- *
Place of Birth :- *
Caste :-
Subcaste :-
Category :- *
Nationality :- *
Permanent Address :- *
State :- *
Pin :-
Telephone No :-
 
Local Address :-
Pin :-
Telephone No :-
 
(To be filled in by college office after Result)
Whether Full Pass or ATKT :- *
Marks of F.E. :-
Total marks obtained
Marks of S.E. :-
Total marks obtained
Marks of T.E. :-
Total marks obtained
Name of the Subject Failed :-
Full Name of Father :-
Mother's Maiden Name :-
Guardian Name :-
Relation with guardian :-
Occupation of Father :-
Fees Details To Be Filled by Students Only
Amount in (RS/-) Fee Recept No. Date DD Number Date
UNDERTAKING
(a) I am seeking admission to SE/TE/BE. I know and understand that my admission to SE/TE/BE is provisional and subject to approval from Directorate of Technical Education, Maharashtra state and eligibility by the University of Pune.
(b) I will abide by rules & regulations of the college and university. I know that any kind of misbehavior or misconduct on my part, is liable for suitable punishment. I undertake that i will not get my self involved in any social or illegal activity inside or out side the college. I also undertake to attend all theory & practicals regularly. I will pay necessary fee from time to time.
__________________________ _________________________________
Date Signature of Student

___________________                      _____________________                                         _________________________
Signature of Clerk                             Registrar                                                         Principal
Note: 1. Xerox copy of Mark Sheet of last examination attended.
           ( To be submitted by the student after declaration of result)
Press Submit Button and then take Print Out of the Form