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1/30/12

ReRegistrationForm

( E- EGI

A IO N FO M)

Re-Registration for Semester Name Program E-Mail ID Contact Address

Enrollment No.

A30601910005

MR RAYAPUDI SIDDARTHA MBA Batch 2010-2012 Date of Birth 16/01/1987

siddhu.ra apudi87@gmail.com H.No:6-94/6/2, Plot No:110, Chanda Nagar, HUDA Colon , H de rabad(Andhra Prade sh)

Pin code Father's Name Parmanent Address

500050

Phone

08647220418, 04023031705

Mobile

9703533817

Fa

R JANARDHAN RAO H.No:6-94/6/2, Plot No:110, Chanda Nagar, HUDA Colon , H de rabad(Andhra Prade sh) 08647220418, 04023031705

Pin code

500050

Phone

Fa

Place of sta during this Se me ste r (Non-Hoste lle rs) With Pare nt Address Cit Pin T elephone e-mail Guardian O wn Arrange me nt

H.No:6-94/6/2, Plot No:110, Chanda Nagar, HUDA Colon , H de rabad 500050 08647220418,04023031705 Mobile 9703533817

siddhu.ra apudi87@gmail.com

Date of pa ment of fees and fee receipt number : ______________________________ Ple ase attach fe e re ce ipt. Are You sta ing in hostel ______________________________ If Yes, Room No. ______________________________

Are ou having an evaluation pending for the previous semester _____________________________________________


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1/30/12

ReRegistrationForm

If es, mention the course(s) and reasons for it ______________________________________________________

I understand that m registration for the Semester mentioned above is provisional and it will stand cancelled in case I do not fulfill the requirements for promotion to the same as per the academic regulation. I also certif that I do not have an pa ment of dues to AGV and I have met all academic deadlines till now

Date : _____________________________

(Signature of the Stude nt)

(Name & Signature of the Ve rif ing Facult )

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