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Examination/Enrolment Form Session: 2020-21

(Candidates will be enrolled in Graphic Era (Deemed to be) University only after producing Migration Certificate (in Original)
from the University / Education Board Studied earlier)
Note To Be Filled Only By First Semester Students

Admission No. 20091197


To,
The Registrar Roll No.
Graphic Era (Deemed to be) University
Enroll. No. GE-

I am applying for Enrolment as a regular student of the university as per details given below. Kindly allot me Enrolment
Number for this University.
1. Full Name of the Student (CAPITAL LETTERS) ADITYA RAJ AGARWAL
(As per High School Certificate)

2. Full Name of the Student (In Hindi) \Ǒ‘×™šȡ‡\‚ȡȡ[›

3. Permanent Address "549/1, Gali No. 2, Bankhandi


Hiralal Road
Rishikesh - 249201"
, Dehradun, Uttarakhand, India, 249201

4. Present Address "549/1, Gali No. 2, Bankhandi


Hiralal Road
Rishikesh - 249201"
, Dehradun, Uttarakhand, India, 249201

5. Father's / Husband's (if married) Name MANOJ AGARWAL

6. Mother's Name(Mrs.) NIDHI AGARWAL

7. Date Of Birth (As per High School Certificate) 30/08/2003 Father Annual Income 1200000

8. Year Of Passing Intermediate (12th) Exam 2020

9. Student Mobile No. 9568123124 10. Father Mobile No. 9840020610

11. Caste / Category General Handicapped No KM No

12. Name Of the Exam Passed...............................................................University/Board..........................................

Year ......................... Institution/College........................................................................................................

Year Name of Exam Roll No. Centre/University/Institute PCM (%) Per. (%) Signature

2018 10th ICSE 68

2020 12th ICSE 69.2

Signature .................................................
Issuing Authority for Migration Certificate
* For Office Use Only :

Migration Certificate No. ........................................ Date .............................University.............................................


........................................................................................................................................................... Received
Migration Fee Rs. ........................................ Receipt No. .......................... Date ..................................... deposited.
Signature ..................................

................................................. ..................................................................
Signature Of the Forwarding Authority Signature Of the Student
(with Seal)(Please Dont Use Facsimile Stamp) (Complete Signature)
Forms with fascimile stamp are not acceptable. Course BACHELOR OF BUSINESS
ADMINISTRATION
Year/Sem 1

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