RAJALAKSHMI ENGINEERING COLLEGE

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REGISTRATION FORM

Name (in capital letters)
date of birth
AGE
WHETher parent / student ?
IF STUDENT, NAME OF THE SCHOOL / COLLEGE
Number of ACCOMPANYING PERSON(S)
MARKS ANTICIPATED / obtained in HSC / INTERMEDIATE (MATHS + PHYSICS + CHEMISTRY)	out of
TOTAL MARKS IN HSC / INTERMEDIATE	out of
RESIDENTIAL address
phone no.
mobile no.
EMAIL ID (IF ANY)
PLEASE MENTION ONE QUESTION YOU WOULD LIKE TO ASK?