INTEGRAL UNIVERSITY, LUCKNOW

DEAPARTMENT OF ……………..
(Semester Registration Form)
Semester: Even Session: 2017-18

Program: …………………….. Semester/ Year: ……………….

Date: ………………
Day: (0/1/2/...): …………. Fine @ Rs. 500 per day from day 1 (Rs.): ………………

Semester Fee Fine Paid for

Student’s Coordinator’s
S.No. Name of Student Enrol. No. Paid vide late registration
Signature Signature
receipt No. vide receipt No.
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Name and Signature Name and Signature Signature

Program Coordinator Head of the Department Dean, Academic Affairs