ONLINE APPLICATION FORM

ATIT 2014

   INSTRUCTIONS:
   Please read instructions before filling this Online Application Form.

1. Name of the Applicant


Upload your Passport Photo




Please upload your recent color Photograph (JPG / GIF format only)
(size 3.5 cm X 4.5 cm)

2. Gender
3. Citizenship
   (Are you an Indian Citizen)
Yes  No
4. Date of Birth
5. Admission Test appearing for JEE/Other Engg. Entrance Tests
6. Academic Record
        Aggregate(%)                Year of Passing
6a. Class X      
6b. Class XI      
6c. Class XII       (For Students who completed Class XII)
7. University/Branch
    Preferences

(Indicate Your Five Preferences)
Ist Preference 2nd Preference 3rd Preference
4th Preference 5th Preference

Note: To reselect the preferences,

8. ADDRESS
8a. Mailing Address1  
8b. Address2 
8c. Address3 
8d. City/Town
9. State
10. Pincode
11. Telephone Number
12. Mobile Number
13. Email ID
14. Name & Address of the College/School (10+2/ Intermediate)
14a. Address Maximum 100 characters 
14b. City
14c. State
14d. Pincode
15. Name of the Board
      (10 + 2 / Intermediate)
16. Syllabus( In class XII ) CBSE    ICSE    State    Others   
17. JEE (Main/Advanced) 2013/State Level/Other National Level Engineering Tests - Application No.
(Please send separately the photocopy of respective Score Card on or before May 31, 2013. )
18. MODE
Payment Mode
19. Declaration

I declare that I have read and clearly understood the rules governing ATIT-2013 and the eligibility criteria for admission into the B.Tech. Program. I hereby agree to abide by the same. I certify that I satisfy the eligibility requirements of the B.Tech. Program as stated in the Prospectus and Application guidelines of B.Tech program and have furnished correct information.

I Agree