CSIR-Central Electrochemical Research Institute
Admission to B.Tech. Programme 2017-18
Other State Quota
Online Application Submission
Note:  
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Online Application Form
 Candidate's Name: 
   
 Father's/Guardian's Name: 
   
 Email-id:  
 
 Re-type Email-id:   
 Category:    Sex:   Mobile No   
 Date of Birth (dd/mm/yyyy):  select date  Age (as on 01.06.2017) : 
 JEE(Main) 2017 All India Rank:  
 Overall Rank:   Category Rank:   Roll No: 

 DD No.     DD Date:    select date   Amount:     Bank:

 Address for Communication with state:  
Exam Passed
  VIII Std IX Std  X Std  +2 or Pre-Degree
 Reg/ Roll No.with month & year of last appearance: 
 Month & Year of Passing: 
 Name of School
 Address of School: with state 
 Name of the Board: 

Marks in Qualifying Examination: HSc (Academic) or Equivalent

 Subject Maximum Marks Marks Obtained % of Marks
 Mathematics
 Physics
 Chemistry
 Total
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