PROFESSOR JAYASHANKAR TELANGANA STATE AGRICULTURAL UNIVERSITY ADMINISTRATIVE OFFICE : RAJENDRANAGAR : HYDERABAD - 500030.
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Application form for Entrance Test of AGRIENGGCET - 2017 1) Name of the applicant : __________________________________
(in block letters)
2) Father’s /Husband’s Name : _________________________________
3) Date of Birth : _________________________________
4) Age as on 31st December 2017: _________________________________
5) Aadhar number : _________________________________
6) Sex : Male / Female
7) Place of birth : __________________________________________
8) State to which you belongs to : __________________________________________
9) Do you belong to BC/SC/ST/
Physically Handicapped / N.C.C. : __________________________________________
(if yes, please tick in appropriate boxes below)
BC-A BC-B BC-C BC-D BC-E SC ST PH NCC SPORTS CAP
10) Details of qualifying examination (enclose certified copies of Memorandum of marks) Academic year Year of
passing Name of the school
/ Polytechnic Village District
4th class 5th class 6th class 7th class 8th class 9th class 10th class Diploma in Agril Engineering 1st year 2nd year 3rd year
11) Particulars of DD : DD No date Bank/Branch:
Address for correspondence (Please include state, telephone details, if any) (Any change in the address may please be intimated immediately)
Name:___________________________________________
S/o:_____________________________________________
H.No:____________________________________________
Village / Mandal:___________________________________
State:________________________Pin:_________________
Mobile Numbers: 1) ________________________________
2) ________________________________
Affix Recent Passport Size Photograph
12) List of enclosures:
i) Proof of Age
ii) Attested copy of the SSC marks memorandum and OGPA report of Diploma.
iii) Latest character certificate issued by the Head of the Institute last attended
indicating that he / she has never been found guilty of misconduct during the study period and never been fined or punished.
iv) Latest Caste Certificate (In case of SC/ST/BC’s) issued by Govt of Telangana v) One self attested envelope with Rs. 5/- postal stamp
(for sending the Hall Ticket).
vi) Three passport size photographs pasted on the application form.
vii) Demand Draft bearing No., date for Rs. 600/- (Rs. 300 in case of SC/ST/PH) drawn in favour of Comptroller, PJTSAU payable at Hyderabad.
viii) Certificates issued by the concerned authorities in the case of special categories like PH, NCC, SPORTS, and CAP.
ix) The filled in form should be sent on or before 03-07-2017 by 5.00 PM to the Convenor, AGRIENGGCET – 2017, Department of Entomology, College of Agriculture, Rajendranagar, Hyderabad - 500030.
SIGNATURE OF THE CANDIDATE
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