PIMPRI CHINCHWAD EDUCATION TRUST'S
S B PATIL INSTITUTE OF MANAGEMENT
Sector No.26,Pradhikaran,Nigdi,Pune-44, Ph.No.020-2765 6900
E-mail ID:
[email protected] Website: www.sbpatilmba.com
APPLICATION FOR RAILWAY CONCESSION
1]Student Name in Full : --------------------------------------- -----------------------
Surname First Name Father’s Name
2] Residential address in Full : -------------------------------------------------------------------
:--------------------------------------------------------------------
Mobile No :--------------------------------------------------------------------
3] Course & Year : ------------------------------------------------------------------
4] Roll No. :--------------------------------------------------------------------
5] Age : -------------------------------------------------------------------
6] Date of Birth : -------------------------------------------------------------------
7] Pass Required from [Place] :---------------------------------To ------------------------------
8] Duration 3/1 Month : ------------------------------------------------------------------
9] No. of Last Certificate : -------------------------------------------------------------------
10] Period of the last pass in Date : ------------------------------To --------------------------------
11] Class of Ticket [I/II] :--------------------------------------------------------------------
12] Caste / Category : -------------------------------------------------------------------
The above information is correct to the best of my knowledge.
Date: - Sign. Of the Student
NOTE: - 1) The certificate will be Valid for Three days including the date of issue.
2) Students will be allowed concession season ticket only from the station
Nearest to their residence to the station nearest to their College.
3) No Fresh Concession certificate should be granted by the college
Authorities to any of their students in the event of his/her session ticket
Being lost during the currency of the previous certificate. Such students
Musts purchase a fresh session ticket at full tariff fares during the periods.
______________________________________________________________________________________________________________
FOR OFFICE USE ONLY
Submit and Issuing concession form Time: - 3.00 p.m. To 5.00 p.m.
Certificate No : ------------------------------
Issued Date : ------------------------------
