ONLINE REGISTRATION FORM 2017

Admission to B.Tech SYNERGY GROUP OF INSTITUTIONS
Please Fill all the Fields Carefully.........
1. Name of the Candidate *
2. E-mail
3. Mobile Number (Parent/Student)
*
(Please give your 10 digit mobile no)
4. Category *
5. Gender Male Female*
6. Courses (Select the branch, One can select branch from both the colleges according to his/her choice.
For Synergy,Dhenkanal *
For Synergy,Bhubaneswar*
Electronis & Telecom. Engg.
Electronis & Communi. Engg.
Computer Science & Engg.
Computer Science & Engg.
Mechanical Engg.
Mechanical Engg.
Electrical Engg.
Electrical & Electronis Engg.
Civil Engg.
Civil Engg.
Electrical Engineering.
7. Date of Birth *
8. Year of Qualifying    Exam. *
9. % of Marks (10th) * (12th)
10. Board of Qualifying
     Examination
*
11. Mailing Address *
(Max. Chars 400)
12. Candidate's
     Residence District
* 13. Neartest      City/ Town
14. Put this exact code in this box : *
Declaration by the Candidate :

I hereby declare that all the particulars stated in this application are true to the best of my knowledge and belief. I also agreed to receive information through SMS & email from time to time.

   

Help Line - 08908004882 , 09437495719

DISCLAIMER: This registration is purely for counselling purpose of SYNERGY GROUP only & may not lead to final admission. No one can calim admission into the institute on basis of this registration without any rank in JEE MAIN 2017.