ST.MARY'S INSTITUTE OF TECHNOLOGY & SCIENCE

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Dear applicant,
After submitting application, pay 400 rupees application fee.( for online fees payment, please contact 7306459474)

Name of the candidate as given in SSLC or Equivalent Certificate In BLOCK letters)

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Annual family income

Address for communication

Name and occupation of

Father Mother Guardian

Occupation

Relation

Requirement of

Hostel College Bus

Name of the qualifying Examination ie, SSLC or equivalent

No. of chances taken.

Have you passed ITI

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If pass, trade of study

Have you passed VHSE

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Have you passed +2

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Branch applied for(mark 1-5 in the preference column according to the preference)

Sl. No	Branches
1
2
3
4
5

Grade/Mark Details of the qualifying examination
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No.	Subjects	Certificates
1	SSLC/ VHSE / CBSE/ ICSE
2	OTHER

DECLARATION

The information given above are true to the best of my knowledge. If any of the information furnished above is found to be false, I have no objection to forfeit my claim for admission

Name of applicant:

Appling For:

Qualifications :

Degree/Diploma/Plus Two/SSLC	specialization	Year of passing	Percentage	Institution	University

Work Experience in Months:

Last drawn Monthly salary:

Expected salary:

Age:

Date of birth:

Gender:

Marital status:

Religion:

Caste:

Phone (Res.):

Permanent Address:

Mobile No.:

Email ID:

Date Of birth

Gender

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st. mary's polytechnic college

04922-256240, 258515 smpcpkd@gmail.com Login

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9544200103

04922-256240
04922-258515

St.Mary's Polytechnic College

Valliyode, Mudappallur P.O

Vadakkanchery,

Palakkad-678 705.

04922-256240,258515
smpcpkd@gmail.com
info@stmaryspolytechnic.com

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