SITM

Personal Details

Name of the student:

Date of Birth:

Gender:

Male Female

Blood Group:

Nationality:

Religion:

Community:

Category:

E-mail ID:

Preference Branch of Engineering (Indicate preference as 1/2/3/4/5)

Branch	Preference
Branch	1	2	3	4	5
Computer Science & Engineering (CSE)
Electrical & Electronics Engineering (EEE)
Electronics & Comm. Engineering (ECE)
Mechanical Engineering (ME)
Civil Engineering (CE)

Academic Details

Examination	Board/Council/Equivalent	Name of the Institution	% of Marks obtained					Total % Aggregate
Examination	Board/Council/Equivalent	Name of the Institution	Eng.	Che.	Phy	Maths	PCM	Total % Aggregate
HSSLC or Equivalent
			Eng.	Sc.	Math.
HSLC
Diploma/B.Sc.

Qualifying Entrance Exams

	Roll No.	Rank
JEE
Assam-CEE
SITM-EE

Family Details

Father's Name:

Father's Occupation:

Father's Tel No.:

Mother's Name:

Mother's Occupation:

Mother's Tel No.:

Permanent Address:

State:

PIN:

Tel No./Mobile:

Address for Communication:

State:

PIN:

Tel No./Mobile:

Declaration

I agree to abide by all the rules and regulations of SITM and Gauhati University, if admitted. I also hereby declare that the information above are correct to the best of my knowledge & belief.

Check List

Attested copy of proof of date of birth.
Attested copies of mark sheet and certificates of Examination starting from HSLC.
A copy of score card of JEE / Assam-CEE
Attested copy of certificate for SC / ST / OBC / Physically handicapped / others.