Appropriate Box
MAHARAJ VIJAYARAM GAJAPATHI RAJ (MVGR) COLLEGE OF ENGINEERING
Phones: 08922-241039/241732-Ext. Fax : 08922-241014 Chintalavalasa, Vizianagaram – 535 005 Permanently affiliated to JNTUK, Kakinada and approved by AICTE, New Delhi Accredited by NBA, NAAC ‘A’ Certified Listed u/s 2(f) & 12(B) of UGC Act 1956 Website: www.mvgrce.edu.in
---------------------------------------------------------------------------------------------------------------REGISTRATION FORM
FOR ADMISSION TO
B.TECH./ B.TECH.(LATERAL ENTRY)/ M.TECH./MBA/MCA
UNDER MANAGEMENT QUATA ( ‘B’ CATEGORY SEATS)
(ACADEMIC YEAR 2013-14)
Please tick mark in the appropriate box for the course you are for: applying
Recent PHOTOGRAPH
UG Programs
B.Tech.(CHEMICAL) B.Tech.(CIVIL) B.Tech.(CSE) B.Tech.(ECE) B.Tech.(EEE) B.Tech.(IT) B.Tech.(MECHANICAL)
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PG Programs
M.Tech. (Machine Design) M.Tech. (VLSI) M.Tech. (CSE) M.Tech. (CNIS) M.Tech. (Structures) MCA MBA : : Male/Female : : :
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1 NAME OF THE CANDIDATE
(as per 10th class certificate)
2 2 3 4 5
GENDER FATHER’S NAME MOTHER’S NAME DATE OF BIRTH ADDRESS
CORRESPONDENCE
PERMANENT
Contact Nos.
MOBILE
LAND NO
6 PARENT/GUARDIAN DETAILS Name: Designation: Annual Income: Contact Nos. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________
MOBILE LAND NO
Page 1 of 2
7
DETAILS OF EDUCATIONAL QUALIFICATIONS
Course Year of passing Institution Board/ University Marks Obtained % of Marks Class
10 class
Inter/CBSE / Other State Exam*
th
*
Diploma Degree/B.Tech. PG Any other In the event of the qualifying examination is from other states furnish the following: State: Affiliated to: Did you enclose equivalency certificate from Board of Intermediate Education? YES/NO DETAILS OF QUALIFYING ENTRANCE EXAMINATION(S)
Phones: 08922-241039/241732-Ext. Fax : 08922-241014 Chintalavalasa, Vizianagaram – 535 005 Permanently affiliated to JNTUK, Kakinada and approved by AICTE, New Delhi Accredited by NBA, NAAC ‘A’ Certified Listed u/s 2(f) & 12(B) of UGC Act 1956 Website: www.mvgrce.edu.in
---------------------------------------------------------------------------------------------------------------REGISTRATION FORM
FOR ADMISSION TO
B.TECH./ B.TECH.(LATERAL ENTRY)/ M.TECH./MBA/MCA
UNDER MANAGEMENT QUATA ( ‘B’ CATEGORY SEATS)
(ACADEMIC YEAR 2013-14)
Please tick mark in the appropriate box for the course you are for: applying
Recent PHOTOGRAPH
UG Programs
B.Tech.(CHEMICAL) B.Tech.(CIVIL) B.Tech.(CSE) B.Tech.(ECE) B.Tech.(EEE) B.Tech.(IT) B.Tech.(MECHANICAL)
Tick mark the appropriate box:
PG Programs
M.Tech. (Machine Design) M.Tech. (VLSI) M.Tech. (CSE) M.Tech. (CNIS) M.Tech. (Structures) MCA MBA : : Male/Female : : :
Tick mark the appropriate box:
1 NAME OF THE CANDIDATE
(as per 10th class certificate)
2 2 3 4 5
GENDER FATHER’S NAME MOTHER’S NAME DATE OF BIRTH ADDRESS
CORRESPONDENCE
PERMANENT
Contact Nos.
MOBILE
LAND NO
6 PARENT/GUARDIAN DETAILS Name: Designation: Annual Income: Contact Nos. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________
MOBILE LAND NO
Page 1 of 2
7
DETAILS OF EDUCATIONAL QUALIFICATIONS
Course Year of passing Institution Board/ University Marks Obtained % of Marks Class
10 class
Inter/CBSE / Other State Exam*
th
*
Diploma Degree/B.Tech. PG Any other In the event of the qualifying examination is from other states furnish the following: State: Affiliated to: Did you enclose equivalency certificate from Board of Intermediate Education? YES/NO DETAILS OF QUALIFYING ENTRANCE EXAMINATION(S)