RAJIV GANDHI UNIVERSITY

Rono Hills, Doimukh,

Arunachal Pradesh- 791112

Transaction No. &

Department / Institute Course Semester Amount
Date

I. PERSONAL DETAILS:

1. Student’s Name:
2. Gender:
3. Roll No.:
4. Registration No.:
5. Mobile No.:
6. Email Id:

II. CORRESPONDENCE ADDRESS

Address:
City:
State:
Pin:

III. DETAILS OF THE LAST EXAMINATION APPEARED

Name of Exam Course Semester Marks obtained %age of marks/ CGPA

Declaration:
I do hereby declare that the above stated information are true to the best of my
knowledge. If any information proves to be wrong, I shall be liable to action as per rules of the
university. I have gone through the rules of admission etc. and shall abide by the same.

Signature of Student