Institute of Engineering & Technology, Lucknow

Provisional Student Registration Form

Acadmic Session: 2019-2020 -O

Year of Admission 2019-2020  

Course Bachelor of Technology  
Branch Information Technology  
Semester 1  
SID on ERP:-
Lateral Entry? No
2019000562
Enrollment No Roll No Allotted 1900520130051
Personal Details
Student's Name Shubham Kesharwani Name in Unicode Hindi शुभम केशरवानी
Date Of Birth 07/04/2001 Gender Male
Father's Name Manoj Kesharwani Father's Profession Farmer
Father's Annual Income Rs. 48000
Mother's Name Seema Kesharwani Mother's Profession House wife
Mother's Annual Income Rs. 0    
Address
Guardian's Name Manoj Kesharwani Guardian's Profession Farmer
G T road saidabad G T Road Father's/ Guardian's 
Father's / Guardian's Address jay70502@gmail.com
Saidabad Email ID
Country India State Uttar Pradesh
City/District Allahabad , Pin Code-221508 Parent's mobile No: 9695791726
Ramanujam hostet Room no
Communication Address Pin Code 226021
106 IET Lucknow
Country India State Uttar Pradesh
City/District Lucknow Student Mobile No. 6387649336
Student's Permanent Address G T Road Saidabad Pin Code 221508
Country India State Uttar Pradesh
City/District Allahabad    
Local guardian's Mobile
Local Guardian's Name and Add.
No.
Admission Details
Whether Belongs To Minority? No Minority Details
Belongs to Area Type Urban Caste Kesharwani
Actual Category General Sub category
Seat Allotted Under Category From SEE (If Applys) General Emergency Contact No. 6387649336
Domicile of State Uttar Pradesh Admitted Through UPSEE
SEE Roll No(if Applys) 12610413 Is Fee Waiver? No
Disability No Type of Disability
Religion Hinduism Email Id shubhamkesharwani2356@gmail.com
Nationality India Hobbies Listening music
Blood Group B+ Identification Mark Mole on left hand
Registering As Student
Other Details (If Any) Regular
Type
Other Information
Aadhar No 353563191214 Is Residing In Hostel? Ýes
Hostel Name Ramanujam Hostel Room No. 106
Scholorship Details
 Whether Receiving Any Scholorship? No    
 Name of Scholorship Being Received -- Amount Per Year Rs. --
Whether Applying For Post Matrix Scholorship of UP Yes Name of Scholorship U.P. govt.
Govt. or Any Other Scholorship? Being Applied
Subjects Choosen-
Sr. No. Group Code Subject Code Subject Name Subject Type
1 KAS102(T) Chemistry (Theory) Theory
2 KAS103 Mathematics-I Theory
3 KCS101(T) Programming for Problem Solving (Theory) Theory
4 KAS102(P) Chemistry (Practical) Practical
5 KCS101(P) Programming for Problem Solving (Practical) Practical
6 KWS101 Workshop Practices Practical
Declaration      
I am aware that I have to attend all the classes as per University ordinance. If my attendance falls below 75%, I may be debarred from appearing in
the examination for which I shall be solely responsible.
I undertake that the information furnished is true to the best of my knowledge and belief. I shall bear the consequences if any of them are found to
be wrong.

Student's Signature   Student's Signature

Submission Date on ERP: 10/09/2019 Print Date: 10-09-2019 02:25:45 PM

       
       
       
       
Seal and Signature of Head Seal And Signature of
Seal and Signature of Faculty Advisor  
of Department Dean Acadmics