10/29/22, 12:21 PM WELCOME TO PRE

 
BOARD OF TECHNICAL EDUCATION, RAJASTHAN, JODHPUR
Lateral Entry in Engineering Program (LEEP-2022)
Direct Admission Application Form

[ DIRECT ADMISSION ]
College (1030) Stani Memorial College of Engg. and Technology, Phagi, Jaipur
Branch 107 : ELECTRICAL ENGINEERING(SFS)
 Form No :    2310982    Form Filled :  29-10-2022  12:20 AM

1. Name of Candidate:   CHAND SHAKER MEENA

2. Father's Name:   LIKHAMI CHAND MEENA
3. Mother's Name:   SUGARO DEVI
4. Gender:   MALE
5. Category-A:   ST
6. Category-B:  
7. Category-C   NONE
8. Date of Birth:   03-09-1997

9. Complete Address:    MEENA BARODA, WAZIRPUR, ,  SAWAI MADHOPUR

 SAWAIMADHOPUR, RAJASTHAN 322219  
10. Phone No:  
11. Mobile No:    9509129136
12. Qualifying Examination Details :    
Education Level : DIPLOMA    
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Branch Group :
Aggregate Marks Obtained
Year of Board/ in Diploma/B.Sc % of Marks
Name of Exam Branch
Passing University Total Marks Obtained
Max. Marks
Obtained
(a) Diploma Electrical Engineering (EE) 2019 BTER 3410 2078 60.94
(b) Degree in Science(B.Sc) with maths as a subject
 
13. State of
     Bonafide Residence:
RAJASTHAN --
14. Religion: :    HINDU 15. Area of Residence RURAL
16. Domicile Distt. OTHER
17. Tehsil  
OTHER
18. Bonafide area NONE    
DECLARATION BY THE CANDIDATE
1. I solemnly affirm that all information furnished by me above, as also in the enclosures is true. I understand that, if any
information furnished therein is found to be untrue in material particulars, I shall be liable to criminal prosecution and
would also be removed from the College. If already admitted. I also affirm that I shall abide by the decisions of the
Centralized Admission Coordination Committee(CACC).
2. I undertake to pay the College, Hostel and other dues regularly, if admitted.
3. I agree, if admitted, to abide by the rules and regulations in force or those that may hereafter be made, for the
administration of the College and I undertake that so long as I remain a student of the College, I will do nothing either
inside or outside the College, I will do nothing either inside or outside the College that will interfere with its orderly
working and discipline.
4. I also declare that:
i) I have never been convicted of any criminal offence, nor have I ever been released on bail in connection with a criminal
case.
ii) No case of criminal offence or moral turpitude is pending against me in any Court of Law.
iii)No complaint or F.I.R has ever been lodged against me by the School/College/University.
Place:
Date: Signature of Candidate

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