Doc No: ADYPU/SOE/F-007

School of Engineering
Issue Date: 1st Sept 2021

Admission / Re-admission Revision No: 0

Document Submission Revision Date: NA

Admission / Re-admission Document Submission

First Name: ___________________ Middle Name: _______________Last Name: __________________
I hereby submitting my documents for the Academic year _________________ for confirming my
admission / re-admission to _____________________ (1st / 2nd /3rd /4th year).
(To be filled by the students)

URN (if allocated)

Contact number
Degree B. Tech M. Tech BCA MCA
Name of Program with
specialization
Year of Study 1st 2nd 3rd 4th
Semester I II III IV V VI VII VIII
Fee paid (Amount)
Receipt Number
Anti ragging on Stamp paper (100 Rs)
Document submission Re – admission application form
Checklist Fee paid Receipt.
Previous semester transcript
(Only For First year / lateral entry / transferred students - To be filled by office)

URN
Official Email ID
Password

Date: Name & Signature Academic Coordinator

I do hereby declare that the information provided by me is true and correct to the best of my
knowledge.
I declare that I fulfill the minimum CGPA criteria (4.5 for undergraduate & 5.5 for postgraduate
programs) for admission / re-admission in the next academic year.

Date: Signature of the Student

(For office use only)

□ Approved & forwarded to

___________________________________
□ Not Approved ___________________________
___________________________________ Dean, School of Engineering