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(RE-REGISTRATION FORM)
Re-Registration
2
for Semester
Enrollment No A7615319002
Name MR ABHISHEK DEY
Program M.Tech. (E&C)
Batch 2019-2021
Date of Birth 05/01/1988
E-Mail ID paku.snehanir05@gmail.com
250 R.B.CHATTERJEE ROAD, (OPPOSITE MURDI
KARKHANA) P.O.LAKURDDI,DIST.PURBA BURDWAN
Contact Address
Purba Burdwan(West Bengal)
Pin code 713102
Phone 9874761798
Mobile NA
Fax NA
Father's Name ADITYA KUMAR DEY
250 R.B.CHATTERJEE ROAD, (OPPOSITE MURDI KARKHANA)
Parmanent P.O.LAKURDDI,DIST.PURBA BURDWAN
Address
Purba Burdwan(West Bengal)
Pin code 713102
Phone 9874761798
Fax NA
Place of stay during this Semester (Non-Hostellers)
Address
City
Pin
Telephone
Mobile
E-mail

Date of payment of fees and fee receipt number : ______________________________

Are You staying in hostel ______________________________ If Yes, Room
No. ______________________________
Are you having any evaluation pending for the previous semester
_____________________________________________
If yes, mention the course(s) and reasons for it________________________________________________

I understand that my Re-registration for the Semester mentioned above is provisional and it will stand
cancelled in case I do not fulfill the requirements for promotion to the same as per the AUUP Regulations
(Regulation No-1 on subject Conduct of Examinations, Scheme of Evaluation and Discipline among
Students in Examinations).I also certify that I do not have any payment due to AUUP and I have met all
academic requirements till now.I shall abide by all rules and regulations of Amity University as per my
undertaking in registration form.
I have also thoroughly read and understood the Policy Guidelines for Information Security. I understand the
contents, and I agree to comply with the said Policy.I further understand that should I commit any violation

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12/17/2019 DIV Contents

of this policy, my access privileges may be revoked and disciplinary action and / or appropriate legal action
may also be taken against me.
Date : _____________________________
(Signature of the Student)
((Name & Signature of the Verifying Faculty))

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