www.myengg.

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1. Program Preference Se le ct First as '1' Se cond as '2'. 2. Name Type your nam e in capital le tte rs as give n in your 10th standard ce rtificate as shown in the e x am ple be low.

BHULABHAI HIRABHAI DESAI

C lick the appropriate option. 4. Category C lick the appropriate option. 5. Gender C lick the appropriate option. 6. Date of Birth

8. Percentage of Marks

10. JEE (Main) 2014 Roll Number

Ente r your JEE (Main) 2014 R oll Num be r as it appe ars on your adm it card. 11. Photograph of the candidate Ple ase upload only JPEG or GIF photo im age of size 50 k b or le ss. 12. Signature of the candidate Le ave this blank . This space is for O ffice use only. 13. Name of the School Type the nam e and de tails of the school whe re you have studie d for the qualifying e x am ination. 14. Postal A ddress Type the nam e and com ple te postal addre ss. C ontact Pe rson Addre ss line 1

C lick the appropriate box . In case of state board, write the nam e of the State only. In case of othe r, write the full nam e of the board.

9. Board of Qualifying Examination

Ente r the actual pe rce ntage of aggre gate m ark s obtaine d in 10th and 12th standard if the re sults are available , othe rwise le ave blank . The pe rce ntage should be rounde d off to the ne are st inte ge r. For e x am ple 62.4% should be writte n as 62 and 76.5% as 77.

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Se le ct the ye ar of passing of qualifying (12th) Ex am ination. For e x am ple , if passe d in 2013 se le ct 2013. Those who are appe aring for qualifying e x am ination in 2014 should se le ct 2014 he re .

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Se le ct the date , m onth and ye ar of your birth as re corde d inYear your of 10th standard ce rtificate . 7. Qualifying Examination

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2013 20064654

HIRABHAI DESAI NETAJI MARG NEAR POST OFFICE NAVRANGPURA

http://ugadmissions.daiict.ac.in/daiictapplicationinstruction.aspx

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3. Nationality

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Addre ss line 2 C ity/Town State 15a. Phone number Ente r 11 digit te le phone num be r starting with 0.

DA-IICT Application Form

NEAR POST OFFICE NAVRANGPURA AHMEDABAD GUJARAT

Dist. Pin.

www.myengg.com
AHMEDABAD 380009

07924512001

15b. E-mail address Ente r your E-m ail addre ss IMP --> All the com m unication will be m ade on the e m ail ID give n by you. No se pe rate postal com m unication shall be done by DA-IIC T. 15c. Mobile Number Ente r your Mobile Num be r

07924512001

16a. Domicile Se le ct your State of Dom icile . 16b. Place of Residence Se le ct your place of re side nce . 17a. Mother's Name Type your Mothe r's nam e in capital le tte rs. 17b. Father/Guardian's name

17c. Relationship with 18b above

Indicate your re lationship with the nam e in para 18b. 18. Declaration by the Candidate

C lick on the che ck box in support of your de claration. 19. Type this case sensitive string in the given box.

Type care fully this case se nsitive alpha num e ric string displaye d on le ft side . 20. How did you come to know about DA -IICT

C lick on the radio button in support of your spe cification. If you se le ct "O the r" the n ple ase spe cify in te x tbox .

http://ugadmissions.daiict.ac.in/daiictapplicationinstruction.aspx

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2014 DA-IIC T, Ne ar Indroda C ircle , Gandhinagar - 382 007, Gujarat, India.

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Type your fathe r/Guardian's nam e as in your Board ce rtificate , if give n. W rite the nam e of your fathe r, if no nam e is give n in Board ce rtificate .

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