Application Form

APPLICATION FOR THE ESTABLISHMENT OF PROGRAMME STUDY CENTRES FOR VERTICALLY INTERATED ENGINEERING PROGRAMMES

Name and address (with Pin Code) of the Applicant Society/Trust/Government/University

Name:

Address:

Pin Code:

STD Code:

FAX No:

Phone No:

E-mail:

(i) Whether the institution is having approval from the relevant statutory body for conducting engineering Programmes. Yes(__) No(__) (Approval letter may be enclosed annexure I) (ii) If approved,names of the existing approved courses may be given below

Sr.No.	Name of the Course	Approved Intake

(Timetable of the classes existing approved courses may be enclosed annexure II)