(RE-REGISTRATION FORM)

Re-Registration for Semester 3

Enrollment No A50504819009
Name MR POOJAN BHALLA
Program BCA
Batch 2019-2022
Date of Birth 24/10/1999
E-Mail ID NA
JG-3/108 B, VIKAS PURI, New Delhi 110018
Contact Address
NEW DELHI(Delhi)
Pin code 110018
Phone 8750563232
Mobile NA
Fax NA
Father's Name TEJPAL BHALLA
JG-3/108 B, VIKAS PURI, New Delhi 110018
Parmanent Address
NEW DELHI(Delhi)
Pin code 110018
Phone 8750563232
Fax NA
Place of stay during this Semester (Non-Hostellers) With Parents
Address 108 b JG 3/ 108B Vikas Puri
City WEST DELHI
Pin 110018
Telephone 8750563232
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 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
academic regulation.I also certify that I do not have any payment of dues and I have met all
academic deadlines till now
Date : _____________________________
(Signature of the Student)
((Name & Signature of the Verifying Faculty))