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NATIONAL INSTITUTE OF TECHNOLOGY PATNA

FIRST CONVOCATION 2009


DEGREE RECEIPENT REGISTRATION FORM

_______________________________________________________
1. Name (English):
(In Capital Letter)

(Hindi): : :M. Tech. / B. Tech. / B. Arch. :Architecture/CE/ECE/EE/ME

2. Institutes Roll No. 3. Degree 4. Branch 5. Email ID:

6. Whether you will receive degree in the convocation in person? (If yes, the candidate must report for rehearsal on 27 January 2009) 7. Name of Organization presently working & Designation:

Yes/No

8. Address for correspondence:

9. Phone: 10. Permanent Address:

Mobile:

DD Details: Rs. 1050.00 as DD amount to be paid in the name of the NIT Patna, payable at Patna. DD No: Name of issuing Bank.. Payable at: . Date: .. City:..

Please fill up this form and send it to the Registration-In-Charge along with a DD of Rs 1050/- (Rs 500/- as registration fee (non refundable) Rs 50/- gown fee (non refundable), and Rs 500/- security money- refundable) in favor of NIT Patna, payable at Patna to reach on or before 20 January 2009.

Note: 1. If a candidate fails to attend the rehearsal on 27.01.2009 at given time, he will not be awarded degree in the convocation. However, the same will be issued to him/her from the Institute counter or sent by post. Candidates are advised to get the rehearsal time confirmed. 2. Convocation gowns shall be issued to candidates on January 27, 2009 from 09:00 hrs to 14:00 hrs and shall have to be returned on January 28, 2009 soon after the convocation is over. Security money Rs. 500/- will be returned to the corresponding candidates after returning their gowns.

(Signature of the applicant)

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