(Sample application form)

Application form for Admission to Direct Second Year of Three/Four Year

Post SSC Diploma Courses in Engineering/Technology for the Academic
Year 2013-2014.
DTE Institute Code:
To
The Principal
----------------------------------------------------------------------------------------------------------------------------(Mention name of institute where student wish to apply for admission and write the DTE Code for the same institute in above box)
1
2
3

Application ID
Name of Candidate
Category:
Open/SC/ST/VJ/DT/NT1/NT2/NT3/OBC/SBC
4 General Merit No published on DTE website
Final Merit List (CAP)
5 Category Merit No published on DTE website
Final merit list (CAP) if applicable
6 Educational Qualification : HSC(Science)/HSC
Vocational/MCVC)/HSC (Bifocal)/ITI/ COE
Mention order of preferences of choice of course as per Educational Qualification:
Preference Name of course
Preference Name of course
No
No
1
6
2
7
3
8
4
9
5
10

Date:

/2013

Signature of Candidate:
Name of Candidate :________________________

Attach attested copies of the relevant documents

1. HSC /ITI/ COE Marksheet
: Yes /No
2. SSC Marksheet
: Yes /No
3. Caste certificate
: Yes /No
4. Non Creamy Layer Certificate valid up to 31/3/2014
: Yes /No
(Applicable in case of VJ/DT/NT1/NT2/NT3/OBC/SBC candidate)
5. Domicile Certificate for type B Candidate
: Yes /No
_________________________________________________________________________________
For office use only
Received application from _______________________________for admission to Direct Second
Year of Three/Four Year Post SSC Diploma Courses in Engineering/Technology for the Academic
Year 2013-2014.
Signature of Receiving Clerk

Institute Code

Seal of institute