Daita Madhusudana Sastry Sri Venkateswara Hindu College of Engineering

(Approved by AICTE and Affiliated to JNTUK-Kakinada)

An ISO 9001:2008 Certified Institution

DMS SVH College of Engineering - MACHILIPATNAM – 521 002, Ph.No. 08672-250450, 251677, 251993

APPLICATION FORM seeking admission to first year B.Tech-Programme

Category – ‘B’ seats (Management Quota) for the academic year2016-17

To be filled-in by the candidate & parent of the candidate:

EAMCET – 2016
Hall Ticket No.
………………… / EAMCET – 2016RANK No.
………………… / Photograph
of the applicant
(candidate)
INTERMEDIATE (12th Standard) Marks
Total Marks in all subjects put together
…………..…….. / Total marks in group
…………..…….. / Class
……………….
Percentage of all subjects put together
…………..…….. / Percentage in group
…………..……..

1st option 2nd option 3rd option

Please indicate course / branch options

Course / Branch: CIV / CSE / ECE / EEE / MEC

Name of the candidate
(in Capital lettersas per SSC memo)
Male / Female
Date of Birth of the candidate
Father’s / Mother’s name,
occupation and
address with PIN code
Contact number & E-mail ID
Nationality, Religion, Category & Sub-Caste
Application fee paid / Cash / DD / NEFT
If NEFT : A/c No.154310011000001,
Andhra Bank, Machilipatnam
IFSC Code: ANDB0001543

We abide by all the rules & regulations and that the particulars furnished above are true & correct.

Signature of Parent / Guardian Signature of the Candidate

We follow the guidelines given by APSCHE.

> (Please see on the reverse side too) >

UNDER TAKING BY THE CANDIDATE & PARENT OF CANDIDATE

1)We give an undertaking that we shall abide by all the rules & regulations and that the particulars furnished above are true & correct. Also, we give an undertaking that the fees will be paid by us, immediately after the selection.

2)We understand that RAGGING is PROHIBITED as per the decision of the Supreme Court of India in writ petition No.(C) 656/1998. Also, we know that Ragging is a cognizable offence and that the offenders will be arrested & punished severely.

3) Tuition fee per year is = Rs. 50,000/-

4) We understand clearly that the tuition fee and the special fees are to be paid by us every year. Also, we give an undertaking that the tuition fee & special fee for each academic year will be paid, in full at a time, before the commencement of each academic year.

Signature of Parent / Guardian Signature of the Candidate

Check List – for B.Tech
EAMCET 2016- Hall Ticket
EAMCET 2016- Rank Card
10th Class (S.S.C.) certificate
Intermediate marks statements (1st2nd years)
Transfer Certificate
Study & Conduct certificate
Caste Certificate if applicable
Five copies of pass-port size photographs
3 sets of xerox copies of all the above certificates

Signature of Parent / Guardian Signature of Candidate