Aieee Registration Form25.06.09

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Engineering Courses Counselling Authority

(Rajiv Gandhi Proudyogiki Vishwavidyalaya)


Airport Bypass Road, Gandhi Nagar, Bhopal – 462 036
Phone: 0755 – 2678 833, Fax: 0755 – 2678 834
Website: www.rgtu.net

AIEEE – 2009 Registration Form


(To be filled by the Candidate himself/herself)
Self Attested
01. AIEEE Roll No. ……………………………………………………. Photograph of
the candidate
02. AIEEE Merit Marks …………………………… All India Rank...……………..
(Attach photocopy of AIEEE score card)

03. Male/Female ………………………………………

04.Whether belongs to (i) J&K Migrant (ii) J&K Resident category (Tick whichever is applicable)

05. Name of the Candidate ………………………………………………………….

06. Father’s Name …………………………………………………………………..

07. Full Address ……………………………………………………………………..

……………………………………………………………………..

……………………………….. Pin Code ………………………...

08. Telephone No. …………………………….. Mobile No. ……………………………….

08. Email Address ……………………………………………………………………………

10. Demand Draft Details:-

Amount DD Number DD Date DD Bank DD City

Rs.

Note:- 1. Please mention AIEEE Roll No., Full Name, Address, Telephone No. and Mobile No. on
the back side of Demand Draft
I am aware that there are approximately only 348 All India seats available and counselling will be conducted till
vacancies exist. Chances of admission are subject to availability of seats. I am filling up this form to take chance
of admission, against vacant seats, if any. I am further aware that registration fee will not be refunded, in case I
am not called for counselling or all the seats are filled before my turn for counselling or I do not get seat of my
choice in the counselling.

Date: / /2009 Candidate’s Signature


Note :
1. Candidate has to fill the choice form alognwith this registration form. In case, seats remain
vacant even after 2nd round of counseling, then seats will be allotted on the basis of choice
submitted as per merit.
2. A candidate can claim eligibility either in J&K migrant or J&K resident seats, but not in both.
3. Candidate with aggregate negative marks in AIEEE – 2009 are not eligible.
Choice Form
Choice No. Institute Name Branch
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
Choice No. Institute Name Branch
48
49
50
51
52
53
54
55
56
57
58
59
60

Candidate's Signature

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