Reg.

No

EWALEME030
UNIVERSITY OF CALICUT
Details of fee remitted
Amount

Chalan No.

Date of remittance

Name of Treasury

170

64259

4-4-2014

friends calicut

Identifying Officer's

................................................................................................................

Name,Designation and Address

................................................................................................................
.........................

Signature of the Candidate.................................................

(To be signed in the Presence of Identifying Officer)

Signature of Identifying Officer with Seal

(To be signed on the Photograph)

B.Tech Supplementary Examination( Semester - 4 ) MAY 2014

APPLICATION FORM
Name of Candidate

AWH ENGINEERING COLLEGE, KUTTIKATUR

MUAD. P.P.

Date of Birth

22.09.1993

Permanent Address

THEKKEPUTHIYOTTIL(HOUSE)
KADALUR(PO)KOZHIKODE
KOZHIKODE(Dt) (Pin) 673531
THEKKEPUTHIYOTTIL(HOUSE)
KADALUR(PO)KOZHIKODE
KOZHIKODE(Dt) (Pin) 673531

Centre and Place of Examination

Present Address

Phone

9633048912
Details of papers for which candidate is applying now
( SUP )

EN09 402

ENVIRONMENTAL SCIENCE

( SUP )

ME09 404

CASTING AND JOINING

( SUP )

ME09 406

THERMODYNAMICS

I hereby certify that the entries made above are correct to the best of my knowledge

Place :

Date :

Signature of Candidate