-
7/27/2019 F12WP143513
1/4
APPLICATION ID: F12WP143513 INSTITUTE COPY
FEDERAL INSTITUTE OF SCIENCE AND TECHNOLOGY (FISAT)TM
(ISO 9001:2000 Certified Engineering College managed by the
Federal Bank Officers' Association Educational Society)
HORMIS NAGAR, MOOKKANNOOR P.O., ANGAMALY - 683 577, KERALA
(Approved by AICTE - Affiliated to Mahatma Gandhi University,
Kottayam)
Website: www.fisat.ac.in E-mail: [email protected]
Category: General
Name: JACOB P REJI
Residential Phone: 04812595859
Mobile Phone: 8714219707
Gender: M
Permanent Address: PLACKIYIL HOUSEARPOOKARA EASTP.O
KOTTAYAM,KERALA
686008
Communication Address: PLACKIYIL HOUSEARPOOKARA EASTP.O
KOTTAYAM,KERALA
686008
Date of Birth: 1995-01-23 Email: [email protected]
Panchayath: ARPOOKARA Nationality: INDIAN
Nationality: INDIAN Religion: Christian
Community: RC Category: General
FBOAES(Member)
Membership No: NA
FBOAES(Patron)
Membership No:
NA
Father's Name: REJI P JACOB Mother's Name: NIMMY REJI
Occupation: BUSINESS Occupation: HOUSE WIFE
Designation: NA Designation: NA
Address: NA Address: NA
Phone: NA Phone: NA
Annual Income: 20000
Kerala
Entrance 2012Roll No: 143513 App No: 1109991 Rank No: NA
Physics and
Chemistry
Mark:21 Max:480
Maths
Mark:35 Max:480
-
7/27/2019 F12WP143513
2/4
Qualifying Exam
Qualifying exam: HSE
Year:2013
Board:HIGHER SECONDARY
BOARD KERALA
Roll No:9123444
Physics
Mark:91 Max:120
Chemistry
Mark:84 Max:120
Maths
Mark:54 Max:100
Branch preferences
Choice1:EEE Choice2:ECE Choice3:EIE Choice4:ME Choice5:CE
Choice6:CSE
Name and address of the school/institution last studied:
GIRIDEEPAM BETHANY HIGHER SECONDARY
SCHOOL,VADAVATHOOR P.O. KOTTAYAM 686010
Phone:
04812571268
Extra-curricular activities:
FOOTBALL
Additional Information:
Payment Information
DD No:384319 DD Date:25-05-2013
Bank:FEDERAL BANK Branch:GANDHINAGAR
Declaration
I hereby declare that i have the eligibility for admission to
B.Tech course as per the rules and norms of MG University and
Govt.of
Kerala. I solemnly affirm that the statement made and
information furnished in my application and also in all the
enclosures there to
submitted by me are true. I declare that, I shall, if admitted,
abide by the rules and regulations of the college. I will not
engage in
any undesirable activity either inside or outside the College
that will adversely affect the orderly working, discipline and
thereputation of the college.
Station: Signature:
Date: Name:JACOB P REJI
If my son/daughter/ward JACOB P REJI is admitted to the
College,I hereby undertake to see to his/her good conduct and
discipline within and outside the College.
Station: Signature:
Date: Name:
Office Use
Certificate is verified by
............................................
Admitted to Branch ..........on
....................................
Administrative Officer / Superintendent F12WP1435136
APPLICATION ID: F12WP143513 INSTITUTE COPY
-
7/27/2019 F12WP143513
3/4
APPLICATION ID: F12WP143513 CANDIDATE COPY
FEDERAL INSTITUTE OF SCIENCE AND TECHNOLOGY (FISAT)TM
(ISO 9001:2000 Certified Engineering College managed by the
Federal Bank Officers' Association Educational Society)
HORMIS NAGAR, MOOKKANNOOR P.O., ANGAMALY - 683 577, KERALA
(Approved by AICTE - Affiliated to Mahatma Gandhi University,
Kottayam)
Website: www.fisat.ac.in E-mail: [email protected]
Category: General
Name: JACOB P REJI
Residential Phone: 04812595859
Mobile Phone: 8714219707
Gender: M
Permanent Address: PLACKIYIL HOUSEARPOOKARA EASTP.O
KOTTAYAM,KERALA
686008
Communication Address: PLACKIYIL HOUSEARPOOKARA EASTP.O
KOTTAYAM,KERALA
686008
Date of Birth: 1995-01-23 Email: [email protected]
Panchayath: ARPOOKARA Nationality: INDIAN
Nationality: INDIAN Religion: Christian
Community: RC Category: General
FBOAES(Member)
Membership No: NA
FBOAES(Patron)
Membership No:
NA
Father's Name: REJI P JACOB Mother's Name: NIMMY REJI
Occupation: BUSINESS Occupation: HOUSE WIFE
Designation: NA Designation: NA
Address: NA Address: NA
Phone: NA Phone: NA
Annual Income: 20000
Kerala
Entrance 2012Roll No: 143513 App No: 1109991 Rank No: NA
Physics and
Chemistry
Mark:21 Max:480
Maths
Mark:35 Max:480
-
7/27/2019 F12WP143513
4/4
Qualifying Exam
Qualifying exam: HSE
Year:2013
Board:HIGHER SECONDARY
BOARD KERALA
Roll No:9123444
Physics
Mark:91 Max:120
Chemistry
Mark:84 Max:120
Maths
Mark:54 Max:100
Branch preferences
Choice1:EEE Choice2:ECE Choice3:EIE Choice4:ME Choice5:CE
Choice6:CSE
Name and address of the school/institution last studied:
GIRIDEEPAM BETHANY HIGHER SECONDARY
SCHOOL,VADAVATHOOR P.O. KOTTAYAM 686010
Phone:
04812571268
Extra-curricular activities:
FOOTBALL
Additional Information:
Payment Information
DD No:384319 DD Date:25-05-2013
Bank:FEDERAL BANK Branch:GANDHINAGAR
Declaration
I hereby declare that i have the eligibility for admission to
B.Tech course as per the rules and norms of MG University and
Govt.of
Kerala. I solemnly affirm that the statement made and
information furnished in my application and also in all the
enclosures there to
submitted by me are true. I declare that, I shall, if admitted,
abide by the rules and regulations of the college. I will not
engage in
any undesirable activity either inside or outside the College
that will adversely affect the orderly working, discipline and
thereputation of the college.
Station: Signature:
Date: Name:JACOB P REJI
If my son/daughter/ward JACOB P REJI is admitted to the
College,I hereby undertake to see to his/her good conduct and
discipline within and outside the College.
Station: Signature:
Date: Name:
Office Use
Certificate is verified by
............................................
Admitted to Branch ..........on
....................................
Administrative Officer / Superintendent F12WP1435136
APPLICATION ID: F12WP143513 CANDIDATE COPY
