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  • B Tech Registration Form 2019

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    Sumit Jangir
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    This document is a registration form for admission to the BK Birla Institute of Engineering and Technology (BKBIET) located in Pilani, Rajasthan. The form requests basic personal information such as name, date of birth, address, category, father's occupation and annual income, JEE Mains exam details, and branch preferences. It also lists the required documents to be enclosed, such as mark sheets, certificates, and Aadhaar card. The completed form along with a registration fee of Rs. 1000 must be submitted for consideration for admission under various categories like management merit, REAP programs, or spot round at the BKBIET campus.

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    B.tech registration form

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    b Tech Registration Form 2019

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    This document is a registration form for admission to the BK Birla Institute of Engineering and Technology (BKBIET) located in Pilani, Rajasthan. The form requests basic personal information such as name, date of birth, address, category, father's occupation and annual income, JEE Mains exam details, and branch preferences. It also lists the required documents to be enclosed, such as mark sheets, certificates, and Aadhaar card. The completed form along with a registration fee of Rs. 1000 must be submitted for consideration for admission under various categories like management merit, REAP programs, or spot round at the BKBIET campus.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    382 views1 page

    B Tech Registration Form 2019

    Uploaded by

    Sumit Jangir
    This document is a registration form for admission to the BK Birla Institute of Engineering and Technology (BKBIET) located in Pilani, Rajasthan. The form requests basic personal information such as name, date of birth, address, category, father's occupation and annual income, JEE Mains exam details, and branch preferences. It also lists the required documents to be enclosed, such as mark sheets, certificates, and Aadhaar card. The completed form along with a registration fee of Rs. 1000 must be submitted for consideration for admission under various categories like management merit, REAP programs, or spot round at the BKBIET campus.

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    © All Rights Reserved
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    of 1

    Form No: 2019-20/_____ (for office use only) #Registration Form Fee: Rs.

    1000/-

    BK Birla Institute of Engineering and Technology


    BKBIET Campus, PILANI, Rajasthan – 333 031 Paste
    passport size
    recent photograph
    Application cum Registration Form for B.Tech Admission under
    Mgt Merit / REAP(Raj) / REAP(OR) / REAP(SPOT)
    Fill the form legibly with neat writing. All the fields are mandatory
    NOTE: Submission of this form does not guarantee the ADMISSION
    Entries 1, 2 and 8 must be as per Secondary Certificate / Marks sheet

    1. Name of the Candidate in full (in ENGLISH) : _________________________________________________________


    Name in HINDI : _________________________________________________________
    2 (a) Father’s Name : (in English)______________________________ (in Hindi) ______________________________
    (b) Mother’s Name: (in English)______________________________ (in Hindi) _______________________________
    (c) Category: (GEN / OBC / SC / ST / Minority / Others) : _______________ (Other than GEN, attach copy of the certificate)
    (d) Occupation and Annual Income of Father / Guardian: ___________________________________________________
    3. Address :_________________________________________________________________________________________
    Post:____________City :_________________ District : ________________ PIN : ___________State : ______________
    Mobile No. (Student): _____________Mobile No. (Parent): ____________ E-mail id : _____________________________
    4. (A). Resident of Pilani? YES NO (B). Studied in BIRLA Schools? YES NO
    5. State of domicile: _____________________ (Attach copy of the Domicile Certificate / Study Certificate for last THREE years)
    6. JEE Mains Exam Details: Roll No.: ________________ Marks Obtained: ______________ Rank: ________________
    7. Branch Opted for: [Write 1/2/3/4/5 against branch name in the following box (1 indicates highest preference and 5 indicates lowest preference) ]
    Computer Science Information Technology Electronics & Communication Electrical Mechanical

    8. Date of Birth as entered in Secondary Certificate:


    9. Aadhaar Number: ____________________________________
    10. Details of Qualifying Examination:
    Name of Roll Board Year of Name and Place CGPA / Total Percentage
    Examination No CBSE / Passing of the School Marks Marks of
    RBSE / Obtained Obtained
    NIOS / Marks
    Others
    Secondary
    (X)
    XI

    Sr. Secondary
    (XII)
    COPY OF THE FOLLOWING AVAILABLE DOCUMENTS TO BE ENCLOSED WITH THIS APPLICATION FORM
    (1). JEE Mains Admission Card or Award Sheet (2). X, XI and XII Marks sheets (3). Character Certificate (XII-School)
    (4). Migration & Transfer Certificate (5). Caste Certificate (other than GEN cat) (6). Aadhaar Card

    DATE : ____________ Signature of candidate (Sign precisely inside the above box) Signature of father / guardian
    #Application downloaded from website, should be submitted with requisite fee in the form of Demand Draft favoring BKBIET- Pilani payable at Pilani only

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