7/11/2016

ReRegistrationForm

(REREGISTRATIONFORM)

ReRegistrationforSemester3

EnrollmentNo.

A13558915031

Name

MRNISHADANUPASHOK

Program

MBA(RE&UI)

EMailID

anup.nishad7@gmail.com

ContactAddress

SarvodayGarden,BuildingNo.5,Roomno.301,NearBhanuSagartalkies,Valipeerroad,Kalyan
(W)

KALYAN(Maharashtra)

Pincode

421301

Father'sName

ASHOKKUMARNISHAD

ParmanentAddress

SarvodayGarden,BuildingNo.5,Roomno.301,NearBhanuSagartalkies,Valipeerroad,Kalyan
(W)

KALYAN(Maharashtra)

Pincode

421301

Batch

Phone

Phone

20152017

9004413666

DateofBirth

Mobile

9022688370

26/05/1992

Fax

9029602996

Fax

NA

PlaceofstayduringthisSemester(NonHostellers)
WithParent

Guardian

Address

NA

City

NA

Pin

NA

Telephone

NA

email

NA

OwnArrangement

Mobile

Dateofpaymentoffeesandfeereceiptnumber:______________________________Pleaseattachfeereceipt.
AreYoustayinginhostel
______________________________

IfYes,RoomNo.______________________________

Areyouhavinganyevaluationpendingfortheprevioussemester_____________________________________________
Ifyes,mentionthecourse(s)andreasonsforit

______________________________________________________

IunderstandthatmyregistrationfortheSemestermentionedaboveisprovisionalanditwillstandcancelledincaseIdonotfulfill
therequirementsforpromotiontothesameaspertheacademicregulation.IalsocertifythatIdonothaveanypaymentofduesto
AUUPandIhavemetallacademicdeadlinestillnow

Date:_____________________________
https://amizone.net/Amizone/WebForms/ReRegistrationForm.aspx

(SignatureoftheStudent)
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7/11/2016

ReRegistrationForm

https://amizone.net/Amizone/WebForms/ReRegistrationForm.aspx

(Name&SignatureoftheVerifyingFaculty)

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