A Y DADABHAI TECHNICAL INSTITUTE, KOSAMBA
Kosamba – Mahuvej Road, Kosamba – Pincode – 394120
MANAGED BY: THE SURATEE SUNNI VOHRA MUSLIM EDUCATION SOCIETY, SURAT
FIRST YEAR DIPLOMA MANAGEMENT QUOTA ADMISSION FORM- (2020-21)
NAME AS PER THE BOARD MARKSHEET                                                                             FORM FEE :200
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STUDENT NAME FATHERS NAME
SURNAME GENDER MALE FEMALE
DATE OF BIRTH
NAME OF BOARD GSEB CBSE / ISCE OTHER (SPECIFY)
BOARD SEAT NO MATHS MARKS
SCIENCE &TECH MARK ENGLISH MARKS
CENTRE NO. YEAR OF PASSING
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ADDRESS CITY
MOBILE NO.
PHOTO OF STUDENT
MARKSHEET
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Note : Payment of registration fees (Rs. 200) must be done as a part of registration using following payment details

Bank Name : HDFC Bank, Branch : Kosamba

AC No : 50100300979820

IFSC CODE : HDFC0000897