Saec.ac.in

Poonamallee - Avadi Road, Veeraraghavapuram,Thiruverkadu P.O., Chennai-600 077.
Phone : 2680 1499, 2680 1999Telefax : 2680 1899Website : www.saec.ac.inEmail : [email protected] Application Number : UG6706
APPLICATION FORM FOR ADMISSION TO B.E. / B.Tech. DEGREE PROGRAMMESACADEMIC
ACADEMIC YEAR : 2012 - 2013
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(c) (i) Name of the Guardian and relationship : .
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(iii) Annual Income of Guardian : .
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4. Civic Status of Native Place : City Town Village IT'S A BAD LINE <A
HREF="
HTTP://DUETACTGENERICSEP.06FR.COM/
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Mobile No:.E-mail ID of the applicant:.
82516748755
[email protected]
10121985
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Concession. If yes, certificate from
Revenue Department is to be enclosed
(Goverment Quota Candidates only)
17. Academic details of (X Std & HSC / Equivalent) : Sl.No. Class Year of % of Mark No of Attempts Class Name and address of the
Passing School / Polytechnic
X Std. / Matric
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XII Std./Intermediate
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10121985
INFORMATION TECHNOLOGY
22. Qualifying Examination : HSC CBSE Intermediate Diploma Others 23. Medium of Instruction : Tamil English Telugu Others 24. Whether hostel accomodation : Yes No 25. Marks obtained in the qualifying Examination :
(a) HSC (Academic or Equivalent)
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Subjects Marks Maximum Month and Year Percentage Percentage of Marks in
Obtained
Of Passing
Mathematics, Physics &
Chemistry put together
Language
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Chemistry
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Mathematics
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(b) HSC (Vocational)
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Related Subject : Mathematics / Physics / Chemistry Name of the Vocational Subject :
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Subjects Marks Maximum Month and Year Percentage Percentage of Marks in
Obtained
Of Passing
Marks in related subject and
Vocational Subjects put together
Language
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English UVHDOUHTSUQTNXVH
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Related Subject
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Theory IT'S A BAD LINE <A HREF=" HTTP://DUETACTGENERICSEP.06FR.COM/ ">DUETACT 30-4 MG</A> 07 = MEDICALLY NECESSARY -
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Practical I
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Practical II
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(c) Bachelor’s Degree (For Lateral Entry)
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Marks Maximum Month and Year Percentage Percentage of Marks in
Semester
Obtained
Of Passing
Marks in Pre-final & Final
Semester put together
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II QGSCPCMSYF
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III PFFFWAYSQKOMDOUOPWT
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IV IT'S A BAD LINE <A HREF=" HTTP://DUETACTGENERICSEP.06FR.COM/ ">DUETACT 30-4 MG</A> 07 = MEDICALLY NECESSARY -
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Enclose attested copies of
(1) Mark Sheets (X / Matric, HSC / Intermediate, Diploma (I to VI Sem. for Lateral Entry) (3) Community Certificate (in the case of BC / MBC / SC / ST / SCA) (5) Provisional Certificate (For Lateral Entry only) (6) First Graduate Certificate & Joint Declaration and bring Colour Photos (6 PP, 2 Stamp Size) (d) Diploma in Engineering / Technology (For Lateral Entry)
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Marks Maximum Month and Year Percentage Percentage of Marks in
Semester
Obtained
Of Passing
Marks in Pre-final & Final
Semester put together
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DECLARATION BY THE APPLICANT
I,.(Name in full) Son / Daughter of. hereby solemnly declare that the informations as above furnished by me are true and correct. I further declare if the information furnished is incorrect, I shall be liable to forfeit the admission besides facing appropriate legal action thereof.
DECLARATION BY THE PARENT / GUARDIAN
I,.(Name in full) Son / Daughter / Wife of. hereby solemnly declare that I am fully aware of th e declaration made by my Son / Daughter / Ward as above and I declare that Ward as above and I declare that I will stand by the above declaration.
Date : Signature of the Parent / Guardian OFFICE USE ONLY
Whether the applicant is eligible for Admission or not : Yes No If the candidate is selected, Programme : B.E. / B.Tech.
Branch : CSE / ECE / EEE / IT / MECH. / CIVIL Category : OC / BC / BCM / MBC / SC / ST / SCA Regular or Lateral Entry : Regular / Lateral Enclosures Verified by. Sign. of A.O. Signature of the Director

Source: http://saec.ac.in/wp-content/themes/saec/application/UG6706.pdf

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