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Name of Board/Uni.
MPEC Registration No. / Non MPEC No. / Seat No. /Enrollment No.:
Month & Year of Passing :
Name of Applicant :(Surname) (Name) (Father’s Name)
Gender : Male Female
Category : Open SC ST SEBC Ex. Serviceman
Discipline from which Diploma passed :
P. H. Y N
H.S.C. Passed : Y N10. Bank Challan No. :
Mobile No. :
ADMISSION COMMITTEE FOR PROFESSIONAL COURSES
L. D. College of Engineering Campus, Ahmedabad-380 015. • Website : www.jacpcldce.ac.in
Admission from Diploma in Engineering Courses to Second Year (Third Semester)of Bachelor of Engineering and Technology Courses (2011-12)
AffixPassport SizePhotographRegistration No.:————Date:——
(For office use only)
1.Read instructions carefully from the website www.jacpcldce.ac.in before filling up theapplication form.2.Use CAPITAL LETTERS only.3.
Candidate who has passed final diploma examination in Nov./Dec. 2010 and April/ May 2011, from TEB / Universities / Institutions situated in Gujarat State areeligible to apply.
4.Form Fee Rs. 350/- is to be paid through bank counter of designeted branches of PNBupto Dt. 17/07/2011 during normal banking hours by producing bank slip (to bedownloaded from website www.jacpcldce.ac.in)5.After filling this form, submit at help centre alongwith bank challan, and xerox copy of allnecessary documents as specified on page No. 3/3 on or before Dt. 17/07/2011 upto5.00 p.m.
CategoryMerit No.Merit MarksTotal MarksPercentageAdmitted AtSignature ofOfficer
Name and Signature of First Scrutinizer :Name and Signature of Final Scrutinizer :
FOR OFFICE USE ONLY