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Application Form for Admission to Amrita B.Tech

Amrita School of Engineering-Amrita Vishwa Vidyapeetham
(Data filled by the candidate on 30/05/2023 6:42 PM)

PERSONAL INFORMATION ADDRESS FOR CORRESPONDENCE

Candidate Name : Suriya N Address Line 1 : E2-303, Raman Vihar
Gender : Male Address Line 2 : Chinnavedampatti
Date of Birth : 2005-05-16 Pincode : 641049
Social Status : OBC(BC&MBC) State : Tamil Nadu & Puducherry (UT)
Email Address : rajkamalsuriya@gmail.com District : Coimbatore
Mobile Number : +91 8847830490 City : Coimbatore North
Alternate Email : suriya95arya@gmail.com
Aadhar Number : 454XXXXXX519
Nationality : Indian
Parent’s / Guardian’s Name : R Nanak Raja
Parent’s / Guardian’s Mobile No : +91 8847830490
How did you know about Amrita ? : Student of Amrita Vidyalayam

JEE Mains Score Details

JEE Application No : 230310050548
JEE Mains Score : 94.2527049

DECLARATION

I Suriya N son/daughter of R Nanak Raja do hereby declare that the facts given by me in the application are true. I shall produce the original
certificates at the time of admission or on demand

Place:

Date:

Signature of the Candidate

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