APPLICATION FORM FOR ADMISSION IN B.Tech. COURSE (Lateral Entry) IN RJIT - 2023
(All India Quota)
To be filled by candidate
Note:
Kindly fill
NA
in all entries which are not available.
Don't leave any field empty. Fill
NA
in Not Applicable fields.
Attach only jpg/jpeg/pdf file. The size of file should not be more than 2MB for successful upload.
Attach any proof of appearing in Qualifying (Graduation) Examination, if
Admit Card/Marksheet
is not available
Graduation Roll No.
*
Name of University
*
Year of Passing/Appearing
*
Aadhar No.
*
Name in full
*
Father's Name
*
Mother's Name
*
Photograph
*
Mobile No.
*
WhatsApp No.
E-Mail ID (Candidate)
*
E-Mail ID (Parents)
Identificatioin Mark of Candidate
Date of Birth (As per 10/12 Marksheet)
*
Gender
*
Male
Female
Other
Nationality
*
Indian
NRI
Domicile
*
M.P.
Non-M.P.
If yes, then attach Domicile Certificate (if not available, attach self-declaration format)
Click Here
to download self-declaration format
*
Economically Weaker Section
*
Yes
No
If yes, then attach EWS certificate issued by the competent authority
*
Tuition Fee Waiver
*
Yes
No
If yes, then attach Income Certificate issued by the M.P. Government
*
Religion
*
Hindu
Muslim
Sikh
Christian
Other
Category
*
Gen
SC
ST
OBC
If Physically Handicapped
*
Yes
No
If yes, then attach appropriate certificate issued by the competent authority
*
Are you a resident of J & K ?
*
Yes
No
If yes, then attach appropriate certificate issued by the competent authority
*
Academic Qualification
*
High School
School Name
Board
Subjects
Year of Passing
Marks Obtained
Max. Marks
Percentage
Higher Secondary
School Name
Board
Year of Passing
Marks Obtained
Max. Marks
Percentage
Graduation/Diploma
Name of Examination
Name of College
Name of University
Subjects/Branch
Year of Passing
Marks Obtained
Max. Marks
Percentage
Correspondance Address
*
Permanent Address
*
Mobile No.
Document Attachments
*
10th Marksheet
*
12th Marksheet
Diploma/Graduation Marksheet/Admit Card (only if result is awaited)
*
