12/17/2018 https://www.convocurrent.gtu.ac.in/convocation.aspx?

x497Z8nR8yNC7GQAv6If1tdogyAd2Rh4

Convocation Year :2018

Gujarat Technological University

Application form for

GTU Degree / Diploma Certificate

141130119037
Institute [113] SAL COLLEGE OF ENGINEERING

1. Name of Applicant : PAREJIYA KEVALKUMAR JAYANTIBHAI

2. Correspondence :

Address : A/2, GOKUL PARK NR. AMBIKANAGAR ODHAV AHMEDABAD Gujarat 382415

Email : kevalparejiya100@gmail.com

Contact. (Phone) : 9909986726 (Mob.) : 9909986726

Aadhar : 974777334139

3. Passing Out Educational Qualification :

BE

Branch : [19] MECHANICAL ENGINEERING

Month & Year passing : Jul 2018

CPI : 6.49

CGPA : 6.97

4. Whether willing to receive degree in person or in absentia (Tick) : Person

5. Transaction Details :
Degree/Diploma Payment Detail
Challan No. : DUA4422743
Total Amount. : 500
Branch Name. : SBI
Challan Date. : 17-Dec-2018
6. Part of GTU Allumni :
Allumni. : NO

: Declaration :
I agree that I have submitted my own detail, the detail are right as per my confirmation. If this information will be wrong then I may be bound with
legal affairs or advocate illegal activity. I am also confirmed that I register here for my own convocation application, if i found with registering other's
information, then GTU can claim illegal activity to me. I must use every effort to keep my password safe and should not disclose it to any other
person. I shall also not permit, either directly or indirectly, any other person to utilize my User ID or password. GTU not responsible, if any other
person misuses the service by logging into your account.

Very Important:
* I have verified all my details (Including Name , Photo & Other Degree Certificate Details) and I
know that it cannot be changed later on after printing Degree Certificate.
Date : 17/12/2018
Place : Signature of Applicant

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