Application Form
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Personal Information
Name of the applicant
*(First Name) (Middle Name) *(Last Name)
Initials, if any Expansion of Initials
Name as it should appear in the college records *Date of Birth
*Gender Male Female *Community
*Father's Name *Nationality
Mother's Name *State of Domicile
Minority Status Marital Status
Religion Caste
Social Status Rural Urban
If belonging to catholic community, specify Diocese  
Note A student shall be treated Rural if he / she passed 10th / 12th from a school located in a village.
Present Address
*Address Line 1 *Mobile No.
Address Line 2 Telephone
*Town/City *Email Address
*Country
*Confirm Email
*State
Alternative Email Address
*District
*Pincode
Permanent Address Same as Present Address? Yes No
Permanent Address
*Address Line 1 *Mobile No.
Address Line 2 Telephone
*Town/City *Email Address
*Country
*Confirm Email
*State
Alternative Email Address
*District
*Pincode
Parent's Details
*Father's Occupation Mother's Occupation
*Total Annual Income
Guardian Details (If Applicable)
Guardian Name Country
Address Line 1 State
Address Line 2 District
Town/City Pincode
Mobile No Relationship with the
Applicant
Upload Your Photo
 
*Do you want to upload your photos now?     Yes  No 
Note If you are not uploading photos now please paste your passport size photograph on the printed form in the box provided.
   
Qualifying Examination Details
Std Name of Institution Board/University Reg. No Year Max Marks Marks Scored Percentage
*10th
*12th
Diploma
*Are the result and details of the qualifying exam available now?     Yes    No   
 
Experience Details (If any, from latest to earliest)
 
Name & Address of Organisation Designation From(mm/dd/yyyy) To(mm/dd/yyyy) Nature of Work Salary Drawn
Note Please attach attested copies of work experience certificates.
Other Details
Please account for break in your academic career, if any
Entrance Examination Details
*Have you appeared/is appearing in any of the Entrance examinations(KEAM/CAT/MAT/GATE etc)?     Yes    No   
Note Please fill relevant fields
   
Course
*Please select Course category
 
UG PG
*How do you propose to fund your Education?
Accommodation and Transport Requirement Detail
Note Subject to availability.
*Do you need hostel accommodation?     Yes    No   
*Do you need transport?     Yes    No   
   
Details of Relatives working in SJCET College
Name Designation
Department Relationship
Family Details (Of Brothers and Sisters)
Relationship Name Occupation Educational Qualification
Awards and Recognitions in Academics and Sports
Awards Year Basis
Hobbies
Hobbies    
Contact Details
Person Name Phone (Landline) Mobile Email
Self
Father
Mother
Guardian
References
1
2
Physical Details
Height (in cm) Weight (in Kgs)
Physically Handicapped Yes No
Language Proficiency
Type Language Writing Reading Speaking
Mother Toungue
Other Language I
Other Language II
Other Language III
What are your life ambitions/goals? How do you propose to achieve them? (250 words)
Write your major achievements in life. (250 words)
   
How did you know about us?
 
How did you know about us?
 
Please Specify
 
Application enclosures
Note The following documents has to be submitted at the time of admission. The applicant is liable to produce any other document if demanded by the concerned authority.
1. E Form( Printout of the online application).
2. Mark list of the qualifying examination (Higher Sec or equivalent)
3. Pass certificate of the qualifying examination (if issued).
4. Migration Certificate, if applicable.
5. Class 10th certificate in original to prove date of birth.
6. Attested copies of PLUS TWO and SSLC mark lists and certificates (3 No.s each)
7. Transfer Certificate from the School/College last attended.
8. Conduct Certificate from the School/ College last attended.
9.Admit Card of the Entrance Examination.
10.Rank certificate of the Entrance Examination.
11.Score card of the Entrance Examination.
12. Allotment Memo from CEE(for Govt. Merit Quota only).
13.Receipt of fee remitted in the Bank (for admission under Govt. Merit Quota).
14.Physical Fitness Certificate in the relevant format given in the KEAM Prospectus.
15. Income Certificate (for reservation category).
16.Community Certificate for SC/ST/OEC/SEBC.
17.Anti-ragging declaration duly filled.
18.Declaration regarding the restriction of Mobile phone.
19.Liquidated damages compliance undertaking.
20.Declaration from NRI sponser (For NRI Quota Only).
21.Copy of passport/employment certificate/Bank Statement (For NRI Quota Only).
22.Passport size photograph (Colour) 5 copies.
Declaration
 

I hereby sincerely and solemnly affirm that, I have read and fully understood the rules, regulations and code of conduct of the college and I promise that I shall follow the same. If I contravene any of the rules and regulations of the college, I am aware that I can be liable to disciplinary action that teh college management may consider necessary and appropriate.

Declaration By Parent
 

I am fully aware of the significance of the above declaration and have understood the same. I agree to all the above conditions.

*Place *Date

  I Agree.  
   
Version 6.01.03