JIMS Engineering Management Technical Campus

Registration Form

 
* mandatory fields

*

Programme :  
    Enrollment number:  
* Scheme: Regular Lateral Entry
     
* Category: General SC ST OBC  
     
* Campus Location:
     
* Full Name:
(The name should be as in the certificate of last examination passed.)
     
* Gender: Male  Female
     
* Date of Birth: [dd/mm/yyyy]
     
* Marital Status: Single Married
     
* Nationality:
     
* Address of Communication:
     
* Telephone Number:    Mobile:
     
* E-mail Id:
     
* Academic Qualifications  
Exam passed
Board/Univ.

Subjects

Year
Aggregate Marks
Percentage
X

XII

Any other Quatification

 
Previous Employment:
Presently Working With:
Any Other Inofrmation:
 
 
 

Date (mm/dd/yyyy) * Place *

Note :: Kindly ensure that all the fields are filled in correctly.