Gujarat Technological University

Re-Assessment for University main Exam

(For all semesters of P.G.Exam, and only Final year semester’s of U.G. & Diploma Courses)

Course & SEM: _______________________Exam held in _________________________________

Institute Code & Name_____________________________________________________________

Enrollment No: ________________________ Seat No: ___________________________________

Name of Student: _________________________________________________________________

TO,

Controller of Examination

Gujarat Technological University

Respected Sir,

I would like to apply for re-assessment in the following subjects in the external theory
portion of the subjects as mentioned below:

Sr. No Subject code for Re-assessment Present Grade

1
2
3
4
5
6

I hereby confirm that all the details provided above are correct & agree that the result declared after re-
assessment will be considered as my final result for the above examination.

Head of Department Signature of Student

For Office Use Only

To be filled in by Institute only

The student has paid sum of Rs. _________as re-assessment fees (Rs. 250/- for one subject and Rs.
500/- for every additional subject) for ______subjects

Institute Seal Principal Signature & Stamp

____________________________________________________________________________________