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Application Form for Admission to Amrita B.Tech Admission 2021

Amrita School of Engineering-Amrita Vishwa Vidyapeetham
(Data filled by the candidate on 06/06/2021 12:22 PM)

PERSONAL INFORMATION ADDRESS FOR CORRESPONDENCE

Candidate Name : Anirudh D Address Line 1 : 23/871, VYSHAKHAM
Gender : Male Address Line 2 : KERA GARDDEN
Date of Birth : 2003-09-29 Pincode : 678623
Social Status : General State : Kerala & Mahe
Email Address : anirudhdevans2003@gmail.com District : Palakkad
Mobile Number : +91 9746107914 City : PUDUSSERY
Alternate Email : devadas1976@gmail.com
Aadhar Number : 310061434169
Nationality : Indian
Parent’s / Guardian’s Name : Devadas C
Parent’s / Guardian’s Mobile No : +91 9633578873
How did you know about Amrita ? : Relatives

AEEE DETAILS
Entrance Examination Mode : Remote Proctored Online Exam(RPOE)

DECLARATION

I Anirudh D son/daughter of Devadas C do hereby declare that the facts given by me in the application are true. I shall produce the original certificates
at the time of admission or on demand

Place:

Date:

Signature of the Candidate

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