APPLICATION FORM
1.

Applicant
Photograph
Paste
here.

COURSE APPLIED FOR
2.
1.

Name of the Candidate in Full (Block Letters)

2.

First Name
Middle Name
Name of Father in Full (Block Letters)

3.

Permanent Address :

Last Name

District
State :

4.

PIN

Telephone No. (with STD code)
Correspondence Address : (If different from above)

Mobile No.

District
State :

PIN

5.

Telephone No. (with STD code)
Nationality :

8.

Date of Birth : DD

10. Academic Qualification :
Name of Exam.
High School/
Secondary
Intermediate/
Sr. Secondary
Graduation
Specify

MM

6. Marital Status : Married
YYYY

Mobile No.
Single
7. Sex : Male

Female

9. Category : Gen/SC/ST/OBC/Other

Board/University

Year

Subject

% age

11. Fee Details :
Demand Draft No.

Bank Name/Branch

Payable at

Date

Amount (Rs.)

Technical Education Organization, Delhi

DECLARATION BY THE STUDENT
I hereby declare that the particulars stated in this form enclosures are true to the best of my knowledge and belief. In the
event supression distrotion like education qualification, nationality etc. made in any application form, any admission/Diploma/
Degree. is liable to for cancellation. Further I also promise to amide by the rules, norm of discipline of the Institute.
Date : _____________
_______________________________
Signature of the Applicant