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APPLIED COLLEGE OF MANAGEMENT AND ENGINEERING (ACME)

Approved by AICTE, Affiliated to M.D. University, Rohtak. 72 Km Stone, NH-2, Delhi Mathura Road, Mitrol, Faridabad-121105 (HARYANA) Ph 01275-206009, EPABX- 099926727, 09996026728 visit us at www.acmecollege.in, email - info@acmecollege.in

APPLICATION FORM FOR ADMISSION TO B.Tech. (SESSION 2007 2008)


Applicant is required to submit duly filled application form along with attested copies of mark sheet of 10+2 , AIEEE rank card, latest photograph at our college or nearest office.

Roll. No. AIEEE All India Rank Haryana State Rank Domicile State

Rank

Preference of Branch (Write 1234 in order of preference)

Computer Science & Engg. Information Technology Electronics & Communication Engg. Mechanical Engg.

Name in Full Space For Photograph

Date of Birth DD Fathers Name MM YYYY

Nationality

Mothers Name

Fathers Occupation

Designation

Annual Income

Office Address

Phone:

Mobile:

Correspondence Address
Address:Address:-

Permanent Address

State:STD Code:Mobile:-

Pin Code :Phone No:-

State:STD Code:Email ID:-

Pin Code:Phone No:-

Details of Examination Passed Examination 10th/Matriculation 10+2/ Intermediate Diploma Any Other Year of Passing Board/ University Marks Obtained Maximum Marks Percentage Division

Details of marks secured in Qualifying Examination (10+2)

Subjects

Mathematics %

Physics %

Chemistry %

English %

Optional Subject %

Overall %

Marks Secured

Category (Please Tick in Appropriate Box)

General

Reserved - If from Reserved Category then mention the same and enclose certificate to this effect

Hostel Facility Required

Yes

No

Dated:______________

Signature of Applicant: