AP Polycet 2015 Application Form
AP Polycet 2015 Application Form
AP Polycet 2015 Application Form
Board
SSC/CBSE/ICSE/NIOS/APOSS
Paste the
Passport size
Photograph in this box
Date of Birth
a.
b.
D
D
M
M
Y
Y
Y
Read the instructions given on the back side of the form.
Use Code only for item No. 4, 6, 7 & 9 as shown in the back page
01.
02.
Father's Name
03.
Date of Birth
05.
Do not Staple/pin
Do not sign on the
Photograph
04. Sex
House No.
Village / Street
District
PIN
Mobile Number
06.
Local / Region
08.
09.
Minority Community
PH
CAP
11. I delcare that I fulfill the eligibility criteria laid down for appearing at POLYCET-2015 and I shall submit all the original
documents in proof at the time of admission into Polytechnics for the acdemic year 2015-16. I also certify that I am not
suffering from any of the following defects, (a) Mentally Rtarfed (b) Deaf & Dumb (d) Deaf & Dumb (d) Chronic Heart, Lung,
Kidney, Liver Diseases (e) Muscular Dystrophy. The information furnished above is true to the best of my knowledge and
belief. In case any false information is furnished by me, I shall be made ineligible for admission and I will have no right to claim.
Item No.
Item Description
04.
Sex
06.
07
Local/Region
Reservation Category
08.
Special Category
09.
Minority Community
Code
Expansion
male
Female
AU
OU
SVU
SV University Area
NL
Non-Local
BCA
BCB
BCC
BCD
BCE
SC
Scheduled Caste
ST
Scheduled Tribe
If eligible place a tick mark ()
in the respective boxes
Christian
Muslim
Parsi
Sikh
Buddhist
Anglo Indian
Any Other
10.
Yes
Urdu Medium
No
Application form should be filled properly and legibly by the student in his/her own hand
writing with ball pen, (blue or black) in CAPITAL LETTERS only.
2.
Only good quality Passport size photograph should be pasted. Please do not staple or pin
the photograph. Please do not sign onthe photograph
3.
Only codes should be entereed inthe boxes provided against items 4, 6, 7, & 9 in the Application Form.
4.
Student has to choose the town/city in which he would like to appear for examination.
5.