Registration Form

1.Select Course*

2. Select Branch*

3. First Name*

Last Name*

4. Gender*

5. Date of Birth*

6. Nationality*

7. Blood Group

8. Differently Abled

9. Category*

Occupation*

10. Father Name*

Father Mobile Number*

Father Email id*

11.Mother Name

Occupation

Mother Mobile Number

12. Present Address

Address*

PIN*

Tel No

Mobile*

E-mail*

13. Permanent Address (if different from above) or checkmark for same

Address*

PIN*

Tel No

Mobile*

E-mail*

14. Local guardian's particulars, if any checkmark

Guardian's Name

Relation

Ph/Mob

15. Educational Qualification

(i) For admission to 1st year of B.Tech/BBA/BCA

Examination	Board/University	Roll No	Year	Max Marks	Marks Obtained	% Marks
10th
(10+2)/equivalent

Marks in 10+2

	Physics	Chemistry	Mathematics	Aggregate PCM
% Marks in 10+2

(ii) For admission to 2nd year of B.Tech (Lateral Entry) LEET Test Information

Examination	Board/University	Roll No	Year	Max Marks	Marks Obtained	% Marks
10th
Diploma

(iii) For admission to M.Tech/MCA/MBA Programme

Examination	Board/University	Roll No	Year	Max Marks	Marks Obtained	% Marks
10th
12th
B.Tech/BA/B.Sc/B.Com/BBA

16. Profile Pic*

17. Declaration*

I hereby certify and declare that,I will submit all document in college.

world college
of technology & management, gurgaon