Application Form BName of the Student (as in X th Grade or Equivalent Exam)Date of BirthGender- Select -MaleFemaleName of the Father (as in X th Grade or Equivalent Exam)Name of the Mother (as in X th Grade or Equivalent Exam)Occupation of the Parent (Mention Office Address): *Annual Income of the Parent:Address for Correspondence:Address Line 1Address Line 2Address Line 3Permanent Address: Same as aboveAddress Line 1Address Line 2Address Line 3Contact Details:Mobile No. of Parent: Mobile No. of Student: Email ID of Parent:Email ID of Student:AADHAAR Number:Student Nationality:Select CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)ReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweState:Religion:Specify:Minority: Yes NoIs PH: Yes NoMarks obtained in the Qualifying Examinations:X th Grade or EquivalentName of the BoardYear Of PassingMaximum Marks or Maximum CGPAMarks Obtained or CGPA ObtainedTotal %Groups %XII th Grade or EquivalentName of the BoardYear Of PassingMaximum Marks or Maximum CGPAMarks Obtained or CGPA ObtainedTotal %Groups %Rank and Marks obtained in the Entrance ExaminationsJEE Mains - 2024Hall Ticket No.JEE Mains Application No.All India-CRL RankNTA ScoreTG-EAPCET - 2024Hall Ticket No.TG-EAPCET Regd No.TG-EAPCET RankMarks ObtainedIndicate order of preference branch-wisePreferenceBranch1- Select -CSEECECSMCSDNOT INTERESTED (NI)2- Select -CSEECECSMCSDNOT INTERESTED (NI)3- Select -CSEECECSMCSDNOT INTERESTED (NI)4- Select -CSEECECSMCSDNOT INTERESTED (NI)5- Select -NOT INTERESTED (NI)Upload Scanned ImagesStudent and Parent declaration We hereby solemnly affirm and declare that all the information provided by us in this application is true to the best of our knowledge.If at a future date any of the information provided by us is found to be false, the management is at liberty to take suitable action against us as it deems fit.Make Payment