BR University

#356355

ADMISSION FORM

Application for Admission into Bachelor of Technology - March 2023 Intake

Course :

Applicant's Name :

Father's Name :

Mother's Name :

Date of Birth :

Mobile :

+91

Gender :

Religion :

Blood Group :

Nationality :

National ID :

Email :

Present Address :

Permanent Address :

Academic Qualifications

Matric Qualification*

Examination :

Board :

Roll No :

Result :

Persentage

Stream :

Passing Year :

Intermediate or Diploma*

Examination :

Board :

Roll No :

Result :

Persentage

Stream :

Passing Year :

Masters Level (if any)

Examination

Result

Persentage

Subject

Passing Year

University

Course Duration

I hereby declare that all the above information are correct and assure that I will abide by all the rules.