Padmanava College

Admission

Registration Form

	Download Affidavit By the Student		Download Affidavit By the Parent/Guardian

Name of Candidate :

Category:

Gender:

Male Female

Email:

Mobile No:

Landline Phone (including STD Code):

Courses:

(Please provide your Preference No. for each course)

Department

Preference No.
(Between 1 -5 )

Computer Science & Engineering
Electronics & Telecommunication Engineering
Electrical & Electronics Engineering
Civil Engineering
Mechanical Engineering

Examination Appeared:

Date of Birth :

Year of Qualifying :

Percentage of Marks:

10^th 12^th Diploma

Board of Qualifying Exam :

Name of Parent /Guardian:

Mailing Address:

Note:
Fields with * symbol are mandatory fields...