Additional Form 193621410

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Pioneer Institute of Professional Studies

(An Autonomous Institute established in 1996)


FOR EXISTING STUDENTS
(To be attached with Admission Form along with Photocopy of
Mark Sheet of Semester I and Semester II)
ATKT Status Details
Roll. No.............................
Name of Student..............................................................
S.N.

Semester

Subject Code and Name

Total ATKT

1
2
3
4

Specialization Choice (Marketing/Finance/Human


Resource/Production/Information System):
1. .....................................................
2. .....................................................

I hereby confirm and declare that the information given above is true and correct. I
am aware that the specialization once opted above will not be changed under any
circumstances.
...............................
(Signature of Student)
.................................
Date:
Place:

(Full Name)

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