DEPARTMENT OF COMPUTER SCIENCE AND ENGINEERING

GRADUATION DAY 2016

REGISTRATION FORM

1. PERSONAL INFORMATION

Name
:
Father / Guardians Name
:
Course studied / Batch/Reg. No :
Residential address
:
Door No / Street
:
City/district/pin code
:
Phone/mobile
:
Email
:
Whether you are getting gold medal

YES / NO

Rank certificate

YES / NO

( delete the irrelevant option inside the box)

2. PROFESSIONAL INFORMATION
Name of the company
:
Mode of selection
: Campus Recruitment

YES / NO

off campus

YES / NO

( delete the irrelevant option inside the box)

Department/division
:
Title/position
:
Salary drawn
:
Location of the company
:
Door no: street
:
City
:
District/State
:
Pin code
:
Office phone no
:
Office fax no
:
Email address
:
3. PG STUDIES INFORMATION
Title of the degree to be received

Program/Course of study

College/University

State

Month/Year of Degree to be awarded

4. OTHER INFORMATION
Mode of receiving degree certificate

In Person

YES / NO

(delete the irrelevant option inside the box)

Number of Persons accompanying you

Whether you are attending the Alumni meet
on the Convocation Day at 10.30 am
(Pl. tick which ever applicable):

Date:

YES / NO (delete the irrelevant options\ inside the box)

Signature of the alumni