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  • Central University of South Bihar: O Ce Use Only

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    Ujjawal Sinha
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    This document is a student membership form for the Central Library at Central University of South Bihar. It collects personal information such as name, enrollment number, program of study, address, and contact details from the student applying for library membership. The form needs to be signed by the student and endorsed by the Head of Department or Dean. It also requires submitting a passport photo and payment receipt along with the completed form.

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    This document is a student membership form for the Central Library at Central University of South Bihar. It collects personal information such as name, enrollment number, program of study, address, and contact details from the student applying for library membership. The form needs to be signed by the student and endorsed by the Head of Department or Dean. It also requires submitting a passport photo and payment receipt along with the completed form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    4 views2 pages

    Central University of South Bihar: O Ce Use Only

    Uploaded by

    Ujjawal Sinha
    This document is a student membership form for the Central Library at Central University of South Bihar. It collects personal information such as name, enrollment number, program of study, address, and contact details from the student applying for library membership. The form needs to be signed by the student and endorsed by the Head of Department or Dean. It also requires submitting a passport photo and payment receipt along with the completed form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    Central University of South Bihar

    द ण बहार के य व व ालय
    Central Library Student Membership Form

    क य पु तकालय छा सद यता फॉम


    Office Use Only Passport size
    User ID / Enrollment No : colour Photo
    (Attested by
    Koha ID : HODs/Dean)

    Date of Registration :
    Date of Expiry :

    Kindly, enclose the photocopy of payment receipt and one additional photograph.

    1. Name : UJJAWAL KUMAR

    2. Father’s Name : MUKESH KUMAR

    3. Mother’s Name : KIRAN KUMARI

    4. Aadhaar Number : 502828632536

    5. Blood Group : O RhD positive (O+)

    6. Enrollment No : CUSB1913125110                  Roll No : 110

    7. Type of Membership

       Student
       Research Scholar

    8. Centre / Department : Department of Law and Governance

    9. Programme / Course : Five Year Integrated B.A.LLB

    10. Physical Disabilities : Not Applicable

    11. Session : 2019 - 2024

    12. Sex : MALE

    13. Address

    a. Present: SAME AS PERMANENT ADDRESS


    b. Permanent : LAXMAN SAHAY LANE, GURUDWARA ROAD, LAXMAN SAHAY LANE,
    GURUDWARA ROAD,, GAYA, BIHAR - 823001

    c. Email : ujjawalkumar84525@gmail.com

    d. Mobile : 7256834974

    14. Specialization (for Research Scholar) :

    Student’s Signature

    Seal and Signature of H.O.D. / Dean

    University Librarian

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