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Government Polytechnic BHUJ 370001
Student Data for Placement 2021
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* Indicates required question
Branch
*
Choose
CIVIL
COMPUTER
ELECTRICAL
MECHANICAL
METALLURGY
MINING
Regular/ C to D Admission
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Regular
C to D
Enrollment Number
*
Your answer
Name ( Please Write your name in Capital letters )
*
Your answer
Father's/ Husband's Name ( Please Write name in Capital letters )
*
Your answer
Surname ( Please Write name in Capital letters )
*
Your answer
Caste
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General
SEBC
ST
SC
Are you physically handicapped (Divyang) ?
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Yes
No
Contact Number
*
Your answer
Whats app Number
Your answer
E Mail ID
*
Your answer
Date of Birth (Please write date according to format)
*
MM
/
DD
/
YYYY
Birth Place
*
Your answer
City/Village
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District
*
Your answer
State
*
Your answer
PIN
*
Your answer
Full Postal Address
*
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Gender
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Male
Female
Transgender
S. S. C. Percentage/Grade
*
Your answer
H. S.C. Percentage/Grade (If you have passed)
Your answer
Semester 1 SPI
*
Your answer
Semester 2 SPI
*
Your answer
Semester 3 SPI
*
Your answer
Semester 4 SPI
*
Your answer
Semester 5 SPI
*
Your answer
Semester 6 SPI
Your answer
Do you have any backlog ?
*
Yes
No
Please mention the name of subject in which you have backlog
Your answer
CGPA
Your answer
CPI
Your answer
Your Height (Please write in Centimeter with one decimal)
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Your Weight (Please write in Kilogram)
*
Your answer
Do you have eye power ? If Yes then write with positive or Negative number
Your answer
After completing diploma What do you want to do ?
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Higher Study
Placement/Job
Self Employee
Freelancer
If Self employee or others then describe in few word
Your answer
Do you want to go abroad (Out of Country) ?
*
Yes
No
Do you want to perform job away from home (Out of taluka or district) ?
*
Yes
No
Any Suggestion if you want to give.
Your answer
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