17/10/2017

JNTUH COLLEGE OF ENGINEERING HYDERABAD (Autonomous)

Kukatpally, Hyderabad - 500 085, Telangana, India
COURSE REGISTRATION FORM:2017-18

1. COURSE IN WHICH ADMITTED & BRANCH : M.Tech in Structural Engineering

2. NAME OF THE CANDIDATE : Swastik Subedi

3. FATHER'S NAME : Prakash Kumar Subedii

4. MOTHER'S NAME : Sunita Subedi

5. MOBILE NUMBER : 7337590789

6. DATE OF BIRTH : 26-11-1992

7. PLACE OF BIRTH : Jhapa, Nepal

8. SEX : Male

9. IDENTIFICATION MARKS : 1. Not Visible 2. Not Visible

10. BLOOD GROUP : A+ve

11. ARE YOU PHYSICALLY CHALLENGED : No

12. NATIONALITY & RELIGION : Others & Hindu

SUB-
13. CATEGORY OF CASTE : OC CASTE : OC

14. DATE OF COUNSELLING : 17-07-2017

15. EAMCET / GATE/ PGECET HT NO. : 9055354 RANK :

16. DATE OF ADMISSION IN THE COLLEGE : 17-07-2017

17. CATEGORY OF ADMISSION : INS

18. PERMANENT ADDRESS
Chandragadi, Bhadrapur - 15, Jhapa, Nepal Tikathali,
: Mahalaxmi -10, Lalitpur, Nepal,Kathamandu,Non India
19. ADDRESS FOR CORRESPONDENCE
International HOstel, JNTUH, Kukatpally, JNTU,
: Hyderabad,,Hyderabad,Non India

20. ARE YOU INTERESTED IN : Music

WOULD YOU LIKE TO JOIN ANY OF THE ABOVE
21. CLUBS IN THE COLLEGE : Yes

22. EMAIL ID (STUDENT) : subediswastik@gmail.com

23. EMAIL ID & MOBILE NO.(PARENT/GUARDIAN) : pksubedi69@gmail.com 9842626205

24. OCCUPATION OF FATHER/GUARDIAN : Private

25. INCOME OF THE PARENT/GUARDIAN : Up to 2 Lakh

Chandragadi, Bhadrapur - 15, Jhapa, Nepal,Tikathali,
26. IF HOSTELLER, LOCAL GUARDIAN'S ADDRESS : Mahalaxmi -10, Lalitpur, Nepal,Non India

27. ARE YOU ELIGIBLE FOR ANY SCHOLARSHIP IF YES, MENTION THE TYPE OF SCHOLARSHIP: No

28. TUTION FEE PARTICULARS : Exempted

DECLARATION BY THE CANDIDATE
I declare that I shall submit ALL THE CERTIFICATES, which are due from me in original within one week from the date of admission in the college, falling which,
I am fully aware that my admission in the college stands cancelled. I assure you that I will not participate in any ragging now & in future. I am aware of the
consequences of getting involved in any ragging incident.

Parent's / Guardian's Signature Candidate's Signature

Date :

For Office purpose only

The candidate is admitted in M.Tech in Structural Engineering for the academic year 2017-18

His / Her Roll No.is ________________________

DEPUTY REGISTRAR PRINCIPAL

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