IKG PUNJAB TECHNICAL UNIVERSITY JALANDHAR

EXAMINATION FORM SPECIAL EXAMINATION: April-16

(To be filled in by student in Block Letters)

Last Date of Submission of Examination Form in Concerned Institute is 30.3.16

Roll No Cum Registration No_______________________________________________________

Course_________________________________________________________________________
Discipline/Branch_________________________________________________________________
Name of the Candidate_____________________________________________________________
Fathers Name______________________________ Mothers Name_________________________

Affixed
photograph

to be attested
By Principal

Name of Institute_________________________________________________________________
Mobile No.: ______________________ Email : ________________________________________
Examination fee(Rs.5000 per Subject): Amount_________________ DD No/ Cash______________
Date____________
Have your ever been disqualified? Yes/No. If Yes, give details_____________________________
________________________________________________________________________________________________
SUBJECTS WITH CODE [ It is compulsory for the student]
Semester:_________

1.______________________2.______________________3. ____________________

4. ____________________5.______________________6.______________________7. ____________________
Semester:_________

1.______________________2.______________________3. ____________________

4. ____________________5.______________________6.______________________7. ____________________
Semester:_________

1.______________________2.______________________3. ____________________

4. ____________________5.______________________6.______________________7. ____________________
Semester:_________

1.______________________2.______________________3. ____________________

4. ____________________5.______________________6.______________________7. ____________________
Semester:_________

1.______________________2.______________________3. ____________________

4. ____________________5.______________________6.______________________7. ____________________
Semester:_________

1.______________________2.______________________3. ____________________

4. ____________________5.______________________6.______________________7. ____________________
Semester:_________

1.______________________2.______________________3. ____________________

4. ____________________5.______________________6.______________________7. ____________________
Semester:_________

1.______________________2.______________________3. ____________________

4. ____________________5.______________________6.______________________7. ____________________
I have gone through the Syllabus and Regulations of
exam and understood the same for my eligibility for
exam. In case of any discrepancy filled in by me in
admission form, I
Shall be responsible for
consequences

the
the
the
the

Certified that the Candidate has completed the prescribed

course of study and fulfilled all the conditions laid down
in the Regulation for the examination and is eligible to
appear in the special examination as a ex-student of
Punjab Technical University, Jalandhar. The candidate
bears a good moral character and particulars filled by
him/her are correct.

Permanent Address of the Candidate

_______________________________
_______________________________

_________________________

_________________________

_______________________________

Signature of the Candidate

Signature of the Principal / Competent

Date_________________

Authority (With Seal and Date)

IKG PUNJAB TECHNICAL UNIVERSITY JALANDHAR

EXAMINATION FORM SPECIAL EXAMINATION: April-16

ADMIT CARD
(To be filled in by student in Block Letters)
Roll No Cum Registration No______________________________________________________

Affixed
photograph
to be attested
By Principal

Name of the Candidate____________________________________________________________

Fathers Name______________________________Mothers Name_______________________
Course________________________________________________________________________
Discipline/Branch_______________________________________________________________
Examination Centre______________________________________________________________
(To be filled By PTU)

SUBJECTS WITH CODE [ It is compulsory for the student]

Semester:_________
1.______________________2.______________________3. ___________________4. __________________
5.______________________6.______________________7. ____________________
Semester:_________
1.______________________2.______________________3. ___________________4. __________________
5.______________________6.______________________7. ____________________
Semester:_________
1.______________________2.______________________3. ___________________4. __________________
5.______________________6.______________________7. ____________________
Semester:_________
1.______________________2.______________________3. ___________________4. __________________
5.______________________6.______________________7. ____________________
Semester:_________
1.______________________2.______________________3. ___________________4. __________________
5.______________________6.______________________7. ____________________
Semester:_________
1.______________________2.______________________3. ___________________4. __________________
5.______________________6.______________________7. ____________________
Semester:_________
1.______________________2.______________________3. ___________________4. __________________
5.______________________6.______________________7. ____________________
_________________

Signature of the Candidate

__________________

Controller of Examinations
IKG PUNJAB TECHNICAL
UNIVERSITY JALANDHAR