Online Admission Registration Form

ONLINE ENQUIRY FORM - Management QUOTA SEATS
ACADEMIC YEAR 2012-13

Welcome to Admission Section Online Enquiry Form!

You may use this form for filling in your Request for Admission in our College for Academic Year 2012-13 in Management Quota. Please fill in latest details and avoid submitting multiple entries. All Fields in this form are mandatory.

Important: This Enquiry form is an attempt to facilitate your ease convenience in submitting Application for Admission to Engineering Courses with us. Submitting this form does not confirm your Admission. College will announce Final Merit Listing as per directives from Maharashtra State Directorate of Technical Education (DTE) and is subjected to change without any prior notice. Please get in touch with College office for latest updates thereof.

TEAM JTM

ONLINE ENQUIRY FORM for Year 2012-13

1) Name:


Surname	First Name	Middle Name	Father's Name

2) Date of Birth:

3) AIEEE/ Maharashtra State CET Registration No:

CET Marks obtained/ Out of: Marks:

Out of:

4) Please select Class in which you want Admission:

5) Caste as per Leaving Certificate:

6) Select Your Admission Category:

7) Gender:

Male Female

8) Marital Status:

9) Details of Father/ Guardian:

a) Mother's Name:

Occupation:

b) Father's Occupation:

c) Guardian Name:

d) Contact Phone No (With STD Code):

(Optional)

10) Permanent Address:

Place/ City: District:
State: Pin Code: (Optional)

11) Correspondence Address:

Use same Address as that of Permanent Address:

Place/ City: District:
State: Pin Code: (Optional)

12) E-mail Address:

(Optional)(required for faster communication)

13) Approximate Annual Income of the Family: (Indian Rs.)

14) Select your First Year Degree Course Admission preference:

12) Details of Qualifying Examination (Std. XII) passed
Month & Year of Passing	Name & Adddress of Institution	Name & Address of Board/ University	Passed from Maharashtra? Yes/ No
			Yes No

Subject	Marks Obtained				Other Information	Remarks/ Result
Subject	Out of	Theory	Practical	Total (PCM )	Other Information	Remarks/ Result
1) Physics					Total Marks obtained:
2) Chemistry				-	Out of Total Marks:
3) Mathematics				-
4) English				-

13) Details of SSC (Std. X) Examination Passed:
Year:		Month:
Total Marks obtained:		Out of Total Marks:

Place:
Date: 20-6-2013

Please do not make multiple Submission. Only One Enquiry form per person will be accepted. Please review your form carefully before submitting. You may also keep a Printed Copy of this Form by Clicking here.This form is being treated as your intent for admission.
By submitting this form you also agree that you will submit the necessary required documents to prove the authenticity of data submitted hereinabove and this application is just a faster means of submission not a confirmation of your admission. We will intimate you with reply e-mail/ contact for confirmation.