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Acharya Motibhai Patel institute of computer studies,

Ganpat vidhyanagar,
Kherva-382711
Dist-mehsana.
Phone-02762-289039

Registration Form for a one day state level event


“PRASHASHT” on 9th October 2010 (Saturday)

Form No______

Name: Sanghvi Bhautik

Address : f-9 block no 540,


Ranjitnagar,
Jamnagar.

Email:bhautiksanghvi2009@gmail.com Contact No:9429141477

Course: MCA Semester:3

College name: JVIMS (MCA)

Address: shah bhagvanji kacharbhai edu.complex,


Near Octrol Post,Indira Marg,
Jamnagar 361001.

University:gujrat technological university

Events:

x Programming Competition: Poster Presentation:

Paper Presentation: Web Designing:

Note: Your filled form should be reached to psm01@ganpatuniversity.ac.in


on or before 30th September 2010. Just make ‘x’ in front of event you want
to participate in. On date of event you need to pay 100 Rs. per event at the
time of Registration. Form No is for office use only. For further information
you may contact on 8980107318, 8980107319.

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