Name of the Applicant*: Father's Name*: Mother's Name*: Category*:GeneralOBCSCST Date of Birth*: Gender*:MaleFemale Mobile No*:+91 Aadhar Card No*: Father's/Guardian's Mobile*: +91 Permanent Address*: City*: State*:Andhra PradeshAndaman and Nicobar IslandsArunachal PradeshAssamBiharChandigarhChhattisgarhDadar and Nagar HaveliDaman and DiuDelhiLakshadweepPuducherryGoaGujaratHaryanaHimachal PradeshJammu and KashmirJharkhandKarnatakaKeralaMadhya PradeshMaharashtraManipurMeghalayaMizoramNagalandOdishaPunjabRajasthanSikkimTamil NaduTelanganaTripuraUttar PradeshUttarakhandWest Bengal Pincode*: Email ID*: Upload Recent Photo (not more than 1MB and Type must be jpg/png/gif)*: DETAILS OF ACADEMIC RECORD: Academic Performance (X* and XII*) Sno. Class Name of School Board Year of Passing Marks Obtained Maximum Marks % 1 X* CBSERBSEICSENIOSOthers 2019201820172016201520142013201220112010 2 XII* CBSERBSEICSENIOSOthers 202120202019201820172016201520142013201220112010 JEE MAINS DETAILS: JEE MAINS Appeared :NoYes JEE Mains Roll No: JEE Mains Percentile: COURSE PREFERENCE* Select three B.Tech disciplines of your preference : 1.CivilComputer ScienceComputer Science(AI)ElectricalMechanical 2.CivilComputer ScienceComputer Science(AI)ElectricalMechanical 3.CivilComputer ScienceComputer Science(AI)ElectricalMechanical PAYMENT DETAILS Admission Application Form Fees is Rs 1000/- Pay through Paytm or Net Banking Take a screenshot of the payment transaction which includes your Transaction ID and Amount. Upload the screenshot Below. For Payment through Paytm, scan the QR code or use phone no. 9928147925 and write 'Admission Form Fees' in Remarks. For Payment through Netbanking,Bank Account details are as follows: Account Name: ANAND INTERNATIONAL COLLEGE OF ENGINEERING Account No: 61147953666 Bank name: SBI Bank Bank Address: SBI Bank, Kanota, Jaipur(Raj) IFSC Code: SBIN0031803 MICR Code: 302002143 Branch Code: 031803 Upload Admission Form Fees Screenshot (not more than 1MB and Type must be jpg/png/gif)*: I hereby understand the terms & conditions mentioned above .I declare that all the details filled by me are correct to the best of my knowledge.