Student Self Assessment Form

Session :……………………………………Course/Stream/Semester………………..………………………………………………..

Name…………………………………………………………. Id/Enrollment………………………………………………………

1 Subject Studied

2 Number of class attended

3 Number of self study hours

4 Number of Practical done

Fully Narrate / describe the

knowledge and skill gained in
5 the above Subject

6 Time Spent

(A) Sports

(B) Social Ethics

In mutual discussions
(C) with other students /
teachers.

Seminars/Conferences
(D)
attended.

In producing any article

(E)
/ material

(F) Industrial training

In any other
(G)
extracurricular activity

In acquiring analytical
(H)
skills / writing skills

(I) In taking care of parents

7 Overall rating out of 10

8 Mobile Number

9 Father Name

10 Father Occupation

11 Email-ID

12 Parent Mobile Number

13 Attending/Non Attending

14 Job/Coaching

15 What you want to become

16 How University help you?

17 Current Status

18 Fee Details

19 Concession (YES/NO)

If YES then by whom?

Percentage of concession
 Declaration by Student:

I hereby declare that the above information provided by me

is true to my knowledge and I feel very happy and satisfied in continuing my further
studies in the University.

Signature of Student

Declaration by Guardian/ Parents

I Father/Mother/Guardian of
(Name of Student) hereby declare that the above information provided by my ward is
true to my knowledge and I am /satisfied /dissatisfied with the performance of my ward
in this Semester/academic year……………………………………

Signature of Parent/Guardian

Mobile No: