NATIONAL EDUCATION SOCIETY - JNNCE



NATIONAL EDUCATION SOCIETY ®

JAWAHARLAL NEHRU NATIONAL COLLEGE OF ENGINEERING

(ESTD. 1980)

SHIMOGA-577 204

(Affiliated to Visveswaraiah Technological University, Belgaum)

APPLICATION FOR ADMISSION TO B.E

DEGREE COURSE IN ENGINEERING

To,

The Principal

J.N.N. College of Engineering

SHIMOGA- 577 204.

| | |

|Name of the applicant in full | |

|(Block Letters) | |

| | |

|Name of the Father/Mother or Guardian | |

|(if parents are not alive) and official Address | |

| | |

| | |

|a) Date of Birth | |

| | |

|b) Age | |

| | |

|a) Permanent Address & Phone No. | |

| | |

| | |

| | |

|b) Address for Communication & Phone No | |

| | |

| | |

| | |

| | |

| | |

|a) Nationality | |

| | |

|b) Religion and Caste (State whether | |

|you belong to Scheduled Caste or | |

|Scheduled Tribe or Backward class or | |

|Backward Tribe or Special Group) | |

|(Caste is for Statistical Purposes only) | |

|a) Home –Town or Village | |

|(With pin code) | |

| | |

|b) Taluk | |

| | |

|c) District | |

| | |

|d) State | |

1. Occupation and Annual Income of the

Parents or Guardian (if Parents are

not alive)

2. Name and Address of local Guardian to

whom reference may be made in case

of need (other than local students)

Phone No.

9. Details of Educational Qualifications:

S.No. Institution Board/University Examination Passed Period of Study % of Marks

10. a) Name of the College/School

Last Attended

b) Address

c) Qualifying Examination Passed

(12th Std/II PUIC/B.Sc/Diploma)

d) Percentage of Marks

Subject in the

Qualifying Exam Max.Marks Min Marks Marks Obtained %

English

Optionals

Physics

Mathematics

Chemistry or

Computer Science or Electroncis

Percentage of Marks in Optionals

(all the three together)

11. Are the following attested copies of

certificates enclosed?

a. Tranfer Certificate

b. Marks Card of Pre-Unversity or

other Qualifying Examination

c. Eligibility Certificate

d. Migration certificate

e. Rank obtained in Entrance

Test Conducted by Government

of Karnataka

f. Medical certificate from a Registered

Medical Practitioner

g. Character & Conduct Certificate

NOTE: ONLY attested copies of

The required Certificates are to be

enclosed with the application and

Originals are to given at the time

of admission.

12. Branch of Engineering which the applicant

prefers to select (State order of Preference)

COMPUTER SCIENCE & ENGINEERING

INFORMATION SCIENCE AND ENGINEERING

ELECTRONICS & COMMUNICATIONS ENGINEERING

ELECTRICAL & ELECTRONICS ENGINEERING

MECHANICAL ENGINEERING

CIVIL ENGINEERING

INDUSTRIAL PRODUCTION & ENGINEERING

TELECOMMUNICATION ENGINEERING

13. Extra Curricular activities.

(Supported by Certificates)

I promise to abide myself by the rules, regulation and orders of the college

authorities and the University. I request you to admit me to B.E Course.

I am aware that RAGGING in any form is PROHIBITED. If I am found indulging in any kind of such undesirable activities, I am liable measures such as dismissal from the college, removal from the Hostel and prevention from taking the

University Examination.

It shall be my responsibility to pay the tuition and other prescribed fees and charges due to the college and Hostel within the prescribed dates, failing which, I become ineligible to attend the classes and to appear for University Examination.

Place : Signature of the applicant

Date :

DECLARATION BY THE PARENT/GUARDIAN

I agree to the applicant’s admission to the First Semester B.E Course of your College. I shall be responsible for payment of all his/her fees and also conduct and good behaviour during the course of his/her stay in the college. I request the Principal to send the progress, performance, behaviour and attendance reports periodically.

Place : Signature of the Parent/Guardian

Date :

-----------------------

Attested

Passport Size Photo

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download