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Application Form For B.Tech.

Application Form For B.Tech. Admission - Management / NRI / NRK Quota

( Fill in the blanks in BLOCK letters or put tick () wherever applicable

Admission Quota
  • * NRI - Non Resident Indian

    * NRK - Non Resident Keralities

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1. Name of the Candidate as in qualifying certificate
2. Permanent Address
Pin
Telephone (with STD)
Mob


3.Address For Communication
Pin
Telephone (with STD)
4. Email
5. Date of Birth
6. Gender
7. Place of Birth
8. Nationality
9. Religion
10. Community
11. Category
12. Mother Tongue
13(a). Father's Name
13(b). Occupation
13(c). Ph.No. with STD code
Mobile No
14(a).Mother's Name
14(b) Occupation
14(c) Ph.No. with STD code
Mobile No
15. Annual Family Income
16. Have you appeared for Kerala Engg. Entrance Exam for the current year
If yes, Roll No.
Rank No.
17 Name and address of the school/institution last studied
Pin
Telephone (with STD)
18. Name of qualifying examination
Board of Examination
Register No
Month & Year of passing
Details of marks secured in qualifying examinations (copy of mark list to be enclosed)
Examination Physics (P) Chemistry (C) Maths (M) Total PCM Total for Exam
Marks Max
Marks
% of Marks Marks Max
Marks
% of Marks Marks Max
Marks
% of Marks Marks Max
Marks
% of Marks Marks Max
Marks
% of Marks
Higher
Secondary
Course
19. Select the order of preference of branches offered
The branches offered are Electronic & Communication Engg. (ECE), Computer Science & Engg, (CSE), Electrical & Electronic Engg. (EEE), Mechanical Engg. (ME) & Civil Engg. (CE)
20. Relationship of applicant with the NRI / NRK (if the admission is under NRI / NRK Quota)
21.Exra-curricular activities:
22.Additional Information, If any
23.How do you come to know about the college
24.Reference Details (If any)
Name of Reference Person
25.Any relatives studying/ studied in MBC
If yes Name and details
26. DD No
Amount
Date
Bank
Branch
27. Upload the following Cetificates [*File size - Maximum 1 MB]
10th Mark list
12th Mark list
12th Pass Certificate (if CBSE/ ICSE)
Transfer Certificate (TC)
Conduct Certificate
Aadhaar Card
KEAM Admit Card
KEAM Data Sheet/ Score Card
Physical Fitness (Medical) Certificate
Migration Certificate
Allotment Memo (For Govt Quota)
Fee Receipt(For Govt Quota)
* Declaration for Provisionally Admitted Candidates

I am aware that the admission is granted to me on the assumption that the Government will grand admission to non-appeared KEAM in NRI quota for lapsed seats as per the last few years practice. In case of denying permission by the Govt the paid money will be refunded. I hereby undertake that I am not eligible to claim any compensation in such a situation.

 


* List of documents enclosed

1). Copy of 10th Standard mark list / Certificates

2). Copy of 12th Standard Mark list

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