Name of the Candidate*
|
|
Date of Birth ( dd/mm/yyyy )*
|
|
Class *
|
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Admission No.*
(Eg: 5978/14)
|
|
Name of Parent/Guardian*
|
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Contact Phone No. with STD Code
of Parent/Guardian*
|
Res :
Office :
Mobile :
|
Home Address for Communication *
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|
Religion, Caste and Community*
|
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Whether Eligible for SC/ST/OEC reservation*
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Yes
No |
Details of previous stay in
MEC Men's Hostel
|
Period :
Room No. : |
Period for which accommodation is
sought for /renewed *
|
From :
To : |
Distance ( in KM ) from Residence to Institution*
|
|
Percentage of Total marks in Physics, Chemistry and Mathematics For First Year B.Tech students only
|
% |
KEAM Entrance Rank For First Year B.Tech students only
|
|
CGPA Last Available
|
|
Annual Income email copy of income certificate to hostel@mec.ac.in
|
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| |