SSAIET - Online Application Form

08/02/2012

B.TECH:

CS IT ME EC

01. COURSE APPLIED FOR:

02. NAME:

03. FATHER'S NAME:

04. FATHER'S OCCUPATION:

05. OFFICE ADDRESS:

06. DATE OF BIRTH OF CANDIDATE:

07. ADDRESS:

08. CONTACT NO.:

09. SEX: MALE FEMALE

10. CATEGORY: MAIN SUB

11. GEN./OBC/SC/ST:

12. DETAILS OF ENTRANCE EXAMINATION:

(A) ROLL NO.:
(B) STATE RANK:
(C) CATEGORY RANK:

13. ACADEMIC QUALIFICATION: (MARKS)

14. SECURITY CODE.:

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