Rashtreeya Sikshana Samithi Trust R.V.COLLEGE OF ENGINEERING (Autonomous Institution Affiliated to VTU, Belgaum) Approved by All India Council for Technical Education, New Delhi
R.V.Vidyanikethan Post, Mysore Road, Bangalore-560059
Phone:080-67178020/21 080-67178026/8161 Fax:080-67178011 Website:www.rvce.edu.in Email ID: [email protected]
APPLICATION FORM FOR ADMISSION TO B.E PROGRAM FOR THE ACADEMIC YEAR
ALL ENTRIES TO BE MADE AS PER ALLOTMENT ORDER
All fields with * are mandatoryFee Details Paid at
KEA /COMED-K /MNGT
Receipt
No* Amount* Date of
receipt*
Paid at RVCE fee-1
Receipt
No* Amount* Date of
receipt*
Paid at Principal Account Fees
Receipt
No* Amount* Date of
receipt*
Paid at RVCE fee-2
Receipt
No* Amount* Date of
receipt*
Branch to which admitted*
AEROSPACE ENGINEERING BIOTECHNOLOGY CHEMICAL ENGINEERING CIVIL ENGINEERING
Type of Admission:REGULAR
1. Name of the candidate (As per SSLC/10th standard Marks Card/PUC/12th Standard Marks card) *
2. Father's Name * 3. Mother's Name * 4. Parent's Occupation
Name of the Organization Parent's Designation/Occupation
Annual Income * Rs:
PAN Number
5. Office Contact Numbers/Fax
Office Number with STD Code STD Code -
Fax Number STD Code -
6. Permanent Postal Address (Provide a copy of the address proof)*
Any change in the postal address to be informed to us with new address proof without fail
City/District*
State * Pin Code *
Landline Number with STD Code STD Code -
Parent's Mobile Numbers Father's Mobile Number*
Mother's Mobile Number
Parent's E-Mail Address Father's Email Address
Mother 's Email Address
7. Name and Address of Local Guardian if any (Provide a copy of the address proof)Any change in the postal address to be informed to us with new address proof without fail
Name of local gaurdian Address of the Local Guardian City/District
State Pin Code
Phone No:(with STD Code) -
Guardian's Mobile Number Guardian Email-ID
8. KEA/COMED-K/AIEEE Details(Tick as applicable)*
Quota *
KEA COMED-K
MANAGEMENT QUOTA KEA-SNQ
ANDAMAN_NICOBAR Round *
FIRST SECOND
SECOND EXTENDED THIRD ROUND Register No.:TAT No.(COMED-K) / KEA No.(KEA)/ AIEEE /
JEE *
Name of the Entrance Examination*
Rank of Entrance Exam*
KEA/COMED-K/Mngt Allotment Order No. * KEA/COMED-K/Mngt Allotment Order Date *
Seat Claimed Category *
GM SC ST I IIA
Mode-1*
GENERAL RURAL
KANNADA MEDIUM HYD KARNATAKA NONE
Mode-2
GENERAL RURAL
KANNADA MEDIUM HYD KARNATAKA NONE
Mode-3
GENERAL RURAL
KANNADA MEDIUM HYD KARNATAKA NONE
Mode-4
GENERAL RURAL
KANNADA MEDIUM HYD KARNATAKA NONE
Allotted Category*
GM SC ST I IIA
Mode-1 *
GENERAL RURAL
KANNADA MEDIUM HYD KARNATAKA NONE
Mode-2
GENERAL RURAL
KANNADA MEDIUM HYD KARNATAKA NONE
Mode-3
GENERAL RURAL
KANNADA MEDIUM HYD KARNATAKA NONE
Mode-4
GENERAL RURAL
KANNADA MEDIUM HYD KARNATAKA NONE
9. Personal Details
Date Of Birth(date/month/year)-- *Date:
01 02 03 Month:
JAN FEB MAR Year:
Age * Mother Tongue
Domicile *:
KARNATAKA NON KARNATAKA
FOREIGN NATIONAL Gender *
MALE
FEMALE Blood Group
O+VE O-VE A+VE B+VE Student's Mobile Number
Student's Email Address * Student's Aadhar card no*
Nationality *INDIAN Religion* Caste 10.
Qualifying Exam Passed *
PUC 12th standard DIPLOMA
Register No. of qualifying examination*
Month and Year of Passing --* Month
JAN FEB MAR -Year Name of the College last attended *
Name of the Board *
Name of the Board*
Place * State *
11. PUC Marks & Percentage * PUC Marks Maximum marks Marks Obtained
PUC-Physics 100
PUC-Maths 100
CHEMISTRY BIOLOGY
COMPUTER SCIENCE ELECTRONICS
100
PUC PCM Marks 300
PUC-Total
PUC PCM Percentage PUC-Percentage 12. In case of Foreign students (Enclose photo copy of passport and
visa)
Nationality
Passport Number Passport Expiry date Visa Number Visa expiry date Embassy Permission letter no Embassy Permission letter date 13. Attested Copies enclosed
a) KEA/COMED-K/Management Allotment order Original & 3 Sets of attested Photo copy * Yes No b) Marks card of 10th standard Original & 3 Sets of attested Photo copy * Yes No c) Marks card of 12th standard/PUC Original & 3 Sets of attested Photo copy * Yes No d) Transfer Certificate (only for ICSE and CBSE studemts) Original & 3 Sets of attested Photo copy * Yes No
e) Migration Certificate Original & 3 Sets of attested Photo copy * Yes No Not Applicable f) Eligibility Certificate issued by VTU Original & 3 Sets of attested Photo copy * Yes No Not Applicable g) Caste Certificate Original & 3 Sets of attested Photo copy * Yes No Not Applicable h) Income Certificate Original & 3 Sets of attested Photo copy * Yes No Not Applicable i) NCC/Sports Certificate Original & 3 Sets of attested Photo copy * Yes No Not Applicable j) Hydrabad Karnataka Certificate Original & 3 Sets of attested Photo copy * Yes No Not Applicable
k) Passport size photographs (03 Nos) * Yes No
14.Interest in Extra Curricular Activities if any(Sports, Cultural &
Other Activities)
15. Has any of your family member/s studied/studying in RVCE? If
Yes, Provide details. * Yes No
Name of the person: 1 Name of the person: 2
Relation Relation
Batch Program Batch Program
Contact Details: Mobile Number Contact Details: Mobile Number
E-mail ID E-mail ID
Present working details: Designation/ USN (If studying currently) Present working details: Designation/ USN (If studying currently)
Name of the organization Name of the organization
Address of the organization Address of the organization
*The information furnished is true to the best of my knowledge and if found false, appropriate action may be initiated against us as deemed fit. I Agree
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