to download Admission form for SY B. Tech. - Rajarambapu Institute ...

Direct SY
Kasegaon Education Society’s
RAJARAMBAPU INSTITUTE OF TECHNOLOGY, RAJARAMNAGAR
APPLICATION FORM FOR THE ADMISSION TO THE HIGHER CLASSES DEGREE
To,
The Principal,
Rajarambapu Institute of Technology, Rajaramnagar
Sir,
I wish to take admission in the collage for higher class. The details are given below. I may please be given admission
to the collage. I have gone through the rules and regulation of institute and I hereby agree to abide by the rules and
regulation.
1)Name :
(As per Higher Secondary Certification) :
2)Date of Birth : Blood Group:
Status(SH/FC/WS/TFW)Scholarship : Sex:
3) Last Examination Result : Exam No. Result:
Last Attended Class Year : Class Roll No. Year
5) Local Address :
6)Permanent Address :
(With Telephone Nos) : Email:
6)Parents or Guardian Name :
Address :
(Telephone No. with STD) :
7) Relation with guardian :
8)Whether belong to reserved cast :
Category
: OPEN/BC/SC/SBC/ST/DT/OBC/NT1/NT2/NT3/VJ/Any
9)Whether Hostel Facility is required : Yes/No, undertaking is given (Over-leaf)
Signature of Student
Enclosed D.D. of Rs. D.D.No. Bank
FOR OFFICE USE
ADMITTED TO ROLL NO. P.R.NO.
ADMISSION INCHARGE REGISTRAR VICE PRINCIPAL PRINCIPAL

UNDERTAKING
I hereby give undertaking as follows-
1) I have carefully gone through the institute‘s code of conduct. I will abide by all the rules of the institute.
2) I have understood that minimum 75 % classroom attendance is necessary for granting term, failing which I
will be detained.
3) I know that any type of misbehavior in the collage / Hostel will lead to cancellation of admission
Signature of Student:
Name of Student:
Date:
Place: