MANIPAL INSTITUTE OF TECHNOLOGY, MANIPAL.

APPLICATION FOR REVALUATION

(No Re-valuation in case practical subjects)

1. Name:_______________________________________________________________________________
2. Semester:_______________________ Branch:____________________________________________
(For which Re-valuation is required)
3. Reg.No.:__________________________Section:_______Exam. Month & Year:_______________
4. Name of the Subjects for Revaluation:
Sl. No.

Code No.

Subject Name

Result (Grade)

5. Amount Paid (*Rs. 500/- per subject)

Rs.___________________Receipt/Challan No.________________ Date:_____________________
Place:
Date:
Signature of the Candidate

DIRECTOR

.
ACKNOWLEDGEMENT
Received the revaluation application form from___________________________________________
Reg. No._______________________Sem.____________ Branch_________________________________
Date:

Signature