etlab | Student Online Application for Academic Year

Mar Baselios Institute of Technology and Science
Nellimattom Post, Kothamangalam

Personal Details

Full Name *

(as per SSLC Book)

Gender *

Blood Group

Date of Birth *

Age *

Nationality *

Community

Phone No *

Email *

Religion *

Caste *

Admission Details

Admission for *

Academic Year *

Priority 1 *

Priority 2 *

Priority 3 *

Contact Details

Present Address

House Name *

Street *

Post / Street 2 *

District *

Pincode *

State *

Country *

Permanent Address [ same as present address ]

House Name *

Street *

Post / Street 2 *

District *

Pincode *

State *

Country *

Parent Details

Father Name *

Mother Name *

Father Occupation

Mother Occupation

Father's \ Guardian's Mobile No *

Mother's Mobile No

Comments From The Student

Reason for selecting this college?

Where did you hear about this College?

Upload Your Photo

Uploaded File

Dimensions should be exactly 150 x 200px, Maximum size 200KB, allowed types .jpg, .jpeg, .png

Image crop / resize tool

Upload Your Signature

Uploaded Sign

Dimensions should be exactly 150 x 100px, Maximum size 100KB, allowed types .jpg, .jpeg, .png

Enter the code as shown in the image below

Verify Code *

Declaration

We hereby declare that the particulars given in this application are true to the best of our knowledge.
We understand and agree that refund of booking amount will not be permitted.

Mar Baselios Institute of Technology and ScienceNellimattom Post, Kothamangalam

B.TECH Lateral Entry Student Online Application 2025

Mar Baselios Institute of Technology and Science
Nellimattom Post, Kothamangalam