Application Form for B.Tech First Year/Lateral Entry Admission into B.Tech. Programme at CIPET IPT JAIPUR 2023

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Central Institute of Petrochemicals Engineeering & Technology Jaipur 2023

Name of the Applicant (as Given in school certificate) *

Email ID *

Mobile Number *

Course Applied for *

B.Tech. in Mechanical Engineering (ME)

B.Tech. in Plastic Technology (PT)

B.Tech Petrochemical Engineering (PC)

Entry Qualification *

12th (Physics, Chemistry & Maths) for B.Tech First Year

Diploma (Completed) for Lateral Entry Admission

B.Sc. (Pursuing Final Year)

Other:

Percentage in 10th Standard *

Percentage in Entry Qualification (12th/Diploma/B.Sc.) *

Gender *

Male

Female

Date of Birth *

YYYY

Category *

General

OBC

Father's / Guardian's Name *

Nationality *

State *

Contact number of Parent *

Complete Address *

Declaration *

I hereby declare that all the particulars stated in this application form are true, complete and correct to the best of my knowledge and belief. I hereby declare that in the event of any information furnished above is false, my admission is liable to be cancelled.

Required

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