Dr.

PUNJABRAO DESHMUKHINSTITUTE OF MANAGEMENT

TECHNOLOGY & RESERCH TECHNOLOGY
DNC College, Nagpur.

: STUDENTS REGISTRATION FORM:

Name of the student ----------------------------------------------------------------------

(In capital letters)

Type of Student : Internal ( ) External ( )
(Tick mark the correct one)

College / Institute name: ----------------------------------------

Organization Name (If Working) -----------------------------------------------------------

-------------------------------------------------------------------------------------------------------

Tel No. ----------------------------------------------------

Mobile: ------------------------------------------------------

Mailing Address: --------------------------------------------------------

Registration Fees: Internal (Same college) Student ` 250/- only.

External (Other college) Students ` 400/- only

Date:

Place: Signature of the Student

Note –Amount shall not refund once registered.

1st Day seminar would be free.

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

Student’s Name :...............................................................

Amount paid : `

Receiver sign.