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Advt 30nov2011 1

The document is a registration form for the 2012 convocation ceremony at Charotar University of Science and Technology. It requests information about the student's degree program, contact details, and payment for attending the ceremony in person or in absence. The form collects the student's name, ID number, program details, contact information, preferred attendance option, number of guests, and payment amount. It must be signed and submitted with payment by demand draft by the specified deadline.

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sohu_7274
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50 views1 page

Advt 30nov2011 1

The document is a registration form for the 2012 convocation ceremony at Charotar University of Science and Technology. It requests information about the student's degree program, contact details, and payment for attending the ceremony in person or in absence. The form collects the student's name, ID number, program details, contact information, preferred attendance option, number of guests, and payment amount. It must be signed and submitted with payment by demand draft by the specified deadline.

Uploaded by

sohu_7274
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CHAROTAR UNIVERSITY OF SCIENCE AND TECHNOLOGY

CONVOCATION - 2012

REGISTRATION FORM

LastDate:- 03/12/2011

PART - I STUDENT INFORMATION


1. Student Name :, 3. Gender :-

2. Student ID No. :4. Degree

:-

5. Institute

:-

6. Faculty

:-

7. Branch

:-

8. Month & Year of Admission

:-

9. Month & Year of Completion

:-

10. CGPA :-

Affix recent
passport
size photo

11. Class Awarded :-

PART - II STUDENT
STUDENTCORRESPONDENCE
CORRESPONDENCEINFORMATION
INFORMATION(Write
(WriteininCapital
CapitalLetters)
Letters)
12. Address

: ______________________________________________________________________________
: __________________________________________________________________ ____________
City :- _________________________________, Pin Code :-____________________
State :-________________________________, Country :- _____________________
Phone (R.) :- __________________________, (O.):- _________________________
(M) :- ______________________________________________
E-Mail Address :- ______________________________________________

PART - III INSTRUCTION FOR PAYMENT OF FEES AND GUEST CHARGE


1.
2.
3.

Fees for IN PERSON is `. 500/- and fees for IN ABSENCE is `. 1000/I will receive the Degree IN PERSON
or IN ABSENCE
( Please tick (P) mark any one)
I will bring ______ guests with me.
(Amount. `)

4.

In Presence : `. 500
In Absence :
`.1000
Guest Charges : `.250 x ____
Total `.
I remit the fees along with Guests Charge (if any) `. _____________/- by way of Demand Draft No. ____________
Date : _____________, Drawn on ______________________ in favour of The Registrar, Charotar University of
Science and Technology, payable at Anand.

PART - IV DECLARATION
I have read & understood the instructions carefully and undertake to abide by the same.
________________________________
Students Signature

Date : ___________________

PART - V FOR OFFICE USE ONLY


Receipt No. ____________________________ , Date : __________________ `. _______________

Form Checked By.

Form Received By

Receiving Date :_________________

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