FILL UP THE DETAILS IN BLOCK LETTERS Reference No:

(For office use)

Name of the Student :

Aadhaar Number (Student) :

Date of Birth :

Gender : Select

Father’s Name :
Preference
Occupation
(Indicate “1” for first preference
Address for Communication: “2” for second and so on)

BE – CIVIL
BE – CSE

BE – EEE

BE – ECE
BE – MECHANICAL
Mobile 1) Parent :
BTech – AI&DS*
2) Student :
BTech – CSBS*

School Last Studied :

HSC/CBSE/ICSE/Others
Board of Study :

PHYSICS CHEMISTRY MATHS

+2 Marks :

Weightage
Cut-off Mark : / 200 Mathematics : 100
Physics : 50
Chemistry : 50

Community : Select

Date:

Attach +2 Mark Sheet

Send the filled in application along with +2 Mark Sheet (Downloaded) to enquiry@psgitech.ac.in
*Subject to the approval of AICTE and Anna University