REGISTRATION FORM
1. (a) Exam Paper For Entrance Test # : EEE - ELECTRICAL AND ELECTRONICS ENGINEERING
(b) Branch Studied at Diploma Level : EEE - ELECTRICAL AND ELECTRONICS ENGINEERING
2. (a) Qualifying Examination# : DIPLOMA Preserve the Registration Number for
(b) Qualifying Exam Hall Ticket No # : 18168-ee-052 all future correspondence.
(c) Year of App./Passing the Qualifying Exam : 2021 REGISTRATION NO. : 4110039566
(d) Place of Study-Diploma/Degree or Equivalent : URBAN
(e) College Code : 168
(f) College Name : GOVT POLYTECHNIC STATION GHANPUR
3. (a) Candidate's Name # : MOHAMMAD YASEEN
:
(b) Father's Name # MOHAMMAD ANKUSHAVALI
:
(c) Mother's Name # : MOHAMMAD SHAHIN SULTAN
(d) Date of Birth (as per SSC or Equivalent) # : 14/09/2002
(e) Birth State, Birth District : TELANGANA - MAHABUBABAD
:
(f) Gender MALE
:
4. (a) Category : BC-B
(b) Do you belong to EWS? # : NA
5. Local Area : OU
6. (a) Non-Minority / Minority : MINORITY
(b) Minority Category
Muslim
7. Annual Income of the Parents (Rs.)
1 Lakh and above - below 2 Lakhs
8. (a) Special Reservation Category : NA
:
(b) Physically Challenged(PH) NA
:
(c) Do you Require Scribe : NO
(d) Sadarem Number N.A
9. (a) Study Details
Class-6 MAHABUBABAD Class-7 MAHABUBABAD
Class-8 MAHABUBABAD Class-9 MAHABUBABAD
Class-10 MAHABUBABAD Inter 1st year / Equivalent N.A
Inter 2nd year / Equivalent N.A Degree N.A
Diploma JANGAON
(b) Place of Study - SSC or Equivalent : RURAL
:
(c) SSC Hall Ticket Number & Year of Passing # 1810103620 , May - 2018
:
(d) Inter Hall Ticket Number & Year of Passing # : N.A
10. (a) Address for Correspondence 1-168, KISTAPURAM,
KESAMUDRAM, MAHABUBABAD,
TELANGANA, 506112
(b)Contact Telephone Number (Mobile) : 7793972802 (c) E-Mail Id :
[email protected] : 479380072545
(d) Aadhaar Card number
11. Regional Centre Preferences
Preference - 1 Preference - 2 Preference - 3 Preference - 4
Warangal Khammam Hyderabad Central Hyderabad South East
12. (a) Fee particulars - Payment through : ONLINE (c) Amount (in Rs.) : 800.00
(b) Payment Reference ID. : TSP411008022FC
# - These Fields CANNOT be edited by the candidate, but written request can be made to the CONVENER, TS ECET - 2021 or email to [email protected] with relevant document proofs.
Remaining fields can be edited by the candidate during the permitted period. For any details contact at 90592 73639 or email to [email protected]
Declaration : I have carefully gone through the instruction booklet and I am conversant with the instructions. I shall abide by the eligibility conditions and other
regulations to be satisfied for appearing at the entrance test and admission into any course prescribed. Further, I assure that I will not involve in any
malpractice or illegal activity in the entrance test. In case, if I furnished any false information or involved in any malpractice or illegal activity, I know
that, I am liable for criminal action as per the existing law. I am responsible for the correctness of the above details filled in by me and the CONVENER, TS
ECET-2021 is not responsible in any way. Mere appearing for the entrance examination does not confer any right for me to take admission.
Date :
30-07-2021 03:47 PM
SIGNATURE of the candidate to be done in the presence of the Invigilator in the provided space below on
the day of Examination in the Examination Hall
Affix a recent color photograph
(3.5 cmX3.5 cm) and get attested by a Gazetted
Officer or the Principal of the College where
studied
(Well in advance BEFORE EXAMINATION)
Note : 1) ALL the candidates have to submit this form in the Examination Hall to the Invigilator.
2) Candidates are not allowed into the Examination Hall even if they are LATE BY A MINUTE.
3) This is computer generated sheet and does not require the signature of the CONVENER, TS ECET - 2021
