Infant Jesus College of Engineering

Name of the student * :

Mobile No. * :

Phone No. :

E-mail * :

Alternative Mobile No. :

Date of Birth :

Place of Birth :

Nationality :

Religion :

Caste :

Community :

Departments * :

Hostel Accommodation required (Optional) :

College Bus Facility :

Name and Address of the Institution in which last studied :

Name of the Father :

Father's Occupation :

Qualification Exam/Degree	Board / University	Registration Number	Year of Passing	Percentage
HSC
Diploma

Permanent Address :

Temporary Address :

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