Download as doc, pdf, or txt
Download as doc, pdf, or txt
You are on page 1of 2

Web Form No.

WA010003

ONLY FOR CONTINUING STUDENTS

FOR OFFICE USE


BATCH
SR
RT

PROGRAMME: ____________
SEMESTER: Spring/Autumn 2011
1.
No.

Registration

Roll No.

2. Please narrate the courses along with course code which you intend to take in this semester:
i. ____________________________________________
ii. ____________________________________________
iii.____________________________________________
iv. ___________________________________________
v. ____________________________________________
vi.____________________________________________
(Tick in the relevant block)
Mr.

Ms.

3. Name:
(NAME IN CAPITAL LETTERS)
4. Father's Name:
(CAPITAL LETTERS)
5. Fee deposited Rs: ____________ (Rupees ____________________________________________________only)
Vide Bank Challan No._____________ Dated: _____________ Bank Branch ______________________________
Note: Please attach the original copy of Challan Form Copy No # 1.
6. Mailing Address (If wants to change otherwise no need to mention) _____________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
Student Signature ________________________
7. FOR OFFICIAL USE.

DISTT

TEH

Bank Code

PRO EDU

OCUP

LVL

CLUS

S.T

L.F

F.T

FEE

Logging ____________Verification _____________ Entry _____________ checking _____________ F.T. Fee

You might also like