EXAMINATION FORM FOR EXAMINATION: May-2011

For Regular Semester Only

Institute Branch Roll No / Name Gender / DOB /B.Gp / Batch Father / Mother Name Mobile / Email / Phone Category Postal Address Beant College of Engg. & Tech., Gurdaspur B.Tech.(Information Technology) 7130811322/Vikalp Male / 09 Dec 1989 / AB+ Parveen kumar/Bandna gupta 9465856264/vikalap.mahajan@gmail.com/01862235418 General S/O Sh.Parveen kumar House no B2,261 mission road garden colony,near Renuika Mandir pathankot(145001) S/O Sh.Parveen kumar House no B2,261 mission road garden colony,near Renuika Mandir pathankot(145001) / gurdaspur Subjects in which appearing Subject Code / Paper Id Semester8 Ind. Trg. Industrial Training/Compulsory / Compulsory Practical Yes Yes Subject Title / Remarks T/P Internal External / 2007 Affix photograph to be attested by principal/ Competent Authority

Permanent Address / Distt

I have understood all the regulations and its amendments in regard to examinations. I found myself Eligible to appear in Examination. In case University declare me ineligible due to any wrong information submitted in examination form by me, I shall be responsible for the consequences at any stage.

Sign of Candidate ________________________

Date___________________

Certified that the Candidate has completed the prescribed course of study and fulfilled all the conditions laid down in the Regulations for the examination and is eligible to appear in the examination as a regular student of Punjab Technical University. The candidate bears a good moral character and particulars filled by him/her are correct.

Signature of the Principal / Competent Authority (With Seal and Date) ________________________

(Signature of HOD)

Receipt of Regular Examination Form and Examination Fee for Examination May-2011 Received Regular Examination Form of Semester8th and Examination Fee of Rs._________________ and late fee (if any) Rs. ___________ from Student Name:Vikalp and Student RollNo:7130811322. Signature of Institute Dealing Head with seal