etlab | BTECH Student Online Application for Academic Year 2023

Personal Details

Full Name *

as per SSLC Book

Gender *

Date of Birth *

Nationality

Admission Details

Admission for *

Academic Year *

Course Preference

Option 1 *

Option 2

Option 3

Type *

Category *

Higher Secondary School Details

Board

Year

Higher Secondary Percentage Obtained

Physics Mark

Chemistry Mark

Maths Mark

Maths & Physics & Chemistry(%)

Overall (%)

Entrance Details

Entrance Rollno

Entrance Rank

Contact Details

Present Address

House Name *

Permanent Address [ same as present address ]

House Name *

Street *

Landmark *

Pin *

District *

State *

Phone No *

Email *

Parent/Guardian Details

Father's Name

Mother's Name

Father's Occupation

Mother's Occupation

Father's \ Guardian's Mobile No

Mother's Mobile No

Parent Email

Select Guardian

Annual Income

Name of Guardian

Relationship with the student

Address of Guardian

Guardian's Phone No

Enter the code as shown in the image below

Verify Code

Declaration

I agree ,The above mentioned facts are true and correct to the best of my knowledge and belief.

BTECH Student Online Application 2023