Admission Form (ME- II) - Modern College of Engineering

6. Date of Birth (dd /mm /yy) :__________________________________________________
7. (a) Do you belong to Backward
Class/S.C./S.T.? : _________________________________________________
(b) If Yes, mention clearly : _________________________________________________
8. Caste :_____________________ Religion:__________________________________________
9. Father’s/Guardian’s Full name :________________________________________________
Address :_________________________________________________
9.1 Mother’s Name - _________________________________________________
10. Father’s/Guardian’s Occupation :_________________________________________________
11. (a) Academic Record :
Course &
Exam
Annual Income : Rs.______________________________________________
College Attended
Month & Yr
of passing
№ of
Attempts
University /
Board
Total Marks
Obtained
Maximum
Marks
(out of)
1 2 3 4 5 6 7 8
I Yr Engg/
Diploma
II Yr Engg
III Yr Engg
B. E.
(Final Yr)
Other Exam
Are you GATE Qualified Candidate
b) Work Experience:
If yes your GATE score
& the year
Name of the Organization/ Industry/Institute Period Nature of Work
Percentage
12. Presently Employed or Unemployed? : Yes / No
If employed, give details (e.g. Designation/Post : _____________________________________
Regular / Temporary, Date of Appointment, :_____________________________________
Length of service etc.)
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