2/22/24, 8:18 PM S.R.T.M.

University : Convocation Form

Swami Ramanand Teerth Marathwada University, Nanded

Application Cum On - Line Registration Details
Application Cum Registraion No. 10710
Registration Date
Receipt Number( For Office use only ) Convocation Form type Presentia

Personal Details

Seat Number ZI13557 UID/Elgibility No. 026/1/2021/302/138

Name the Student LANDGE SURAJ SHRIMANT
Name of Examination Passed B.C.A.
Class Obtained Not Applicable
Grade Obtained Not Applicable
Year SUMMER - 2024 (Appear)
Mobile Number 9021640037 e - mail Address surajsl309@gmail.com
Optional Subject or Specialisation BCA
College Code 302

Residential Address

Flat/Area KAREPUR
Area/Street KADEPUR At. Post. KAREPUR
Tq. RENAPUR Dist. LATUR
State MAHARASHTRA Pin Code Number : 431522

Fees Details

University Receipt No. / Bank D.D. No. Date Amount

Name of Bank
I have read & understood the instructions carefully and undertake to abide by the Same.

IDENTITY CERTIFICATE

I ( wirte name of the person who attested photogrphy )

hereby certify that the marginal photography of LANDGE SURAJ SHRIMANT has been attested
by me and that the applicant has signed in my Presence

Signature of Attesting Person

Photography to be attested by the Principal/Teacher of an with Stamp

affillated college,Teacher of the Campus School

Write Your Name ( In Devnagri Script e.g. Marathi,Hindi etc., )

Note (Version 2.0) : Print the Application Cum Online Registration form and Submit it with necessary fees and essential documents .A Certified copy of the
statement of marks of all the years, Internship Certificate or Training Certificate as the case may be along with application form on College or Convocation Section
of ; S.R.T.M.University as per Notification issued time to time.
I here by declared that, the above information is verifyed and found correct, I will not modified information after ther printing of application

Signature of Applicant
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