#27, Knowledge Park-III, Greater Noida-201306 (Uttar Pradesh)
 
APPLICATION FORM FOR ADMISSION TO B.TECH/M.B.A/M.C.A
(SESSION 2017-2018)
 
Instructions:
 
1. Please read Information Brochure carefully before filling each items of Application Form.
2. No column should be left blank, write N.A. if not applicable.
3. To apply for MBA, please select the Branch applied for as "Master of Business Adm." and enter your MAT Score in the field specified below. Please enter "N.A." in the State Roll No./Rank fields.
4. To apply for MCA, please select the Branch applied for as "Master of Computer App.". Please enter "N.A." in the State Roll No./Rank fields and MAT Score field.
Branch Applied For

  Please enter your MAT score only to apply for MBA
  MAT/CAT Score:   CMAT Score:

 Please enter your State Roll No./Ranks only to apply for B.Tech
 
Roll No.
Rank
 JEE(Main)
 UP-SEE
 12th Class
 
 
 
Name
         
 
Date of Birth
Nationality    
 
Father's Name
Qualification
Designation
Occupation
Mother's Name
Qualification
Designation
Occupation
 
Category  
 
Permanent Address   Postal Address
     
  Address
 
  State
  Pin Code
  STD Code
  Phone No.
  Mobile No.
  E-Mail ID
 
  Address
 
  State
  Pin Code
  STD Code
  Phone No.
  Mobile No.
  E-Mail ID
 
 
Educational Qualification
 
 
Passing
Year
Board /
University
Marks
Obtained
Maximum
Marks
% age   Division
 
10th
%
   
12th
%
   
Diploma
%
   
B.Tech/B.Sc/
B.Com/B.A.
%
   
Other
 
%
 
Date : 26/4/2017
   
Declaration : Certified that all entries in this form are correct.