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Fol

l
owi
ngI
nfor
mat i
on/Documentr
equi
redf
orUni
ver
sit
y
Regi
str
ati
on.(Sendwi
thi
nazipfi
le)
A.FI
LLTHEFORM,
TAKEANI
MAGEANDSENDTHEI
MAGEI
NZI
PFI
LE

1.St
udentName:ASHISH KUMAR R

2.Fat
her
'sName:

3.Mot
her
'sName:

4.Dat
eOfBi
rt
h:

5.Cat
egor
y:

6.Sex:

7.Bl
oodGr
oup:

8.Rel
i
gion:

9.Addr
ess:

10.St
ate:

11.Di
str
ict:

12.Pi
nNo:

13.Cont
actNo: 14.AadhaarNo:

15.Emai
lId :

16.(
10+2)
thPassi
ngYear: 17.(
10+2)
thReg.No:

ForBTechRegul
ar/BTechLat
eral
/MTechSt
udent

Examinat
ion Exami
nat
ion Boar
d/Counci
l Mark Cl
ass/
Div
isi
on DGPA/
CGPA
Type Name Obt
ained

Cl
ass12

Di
ploma

BE/
BTech
B.SENDTHEDOCUMENTSASI
MAGEFORMAT(
Onl
y.j
peg/
.j
pgf
ormatwi
th200kbi
s
al
lowed)

1.WBJEE/
JEE-
MAI
N/CET/
PGET Al
l
otmentl
ett
er/RankCar
d

2.Phot
oOfSt
udent

3.Si
gnat
ureOfSt
udent

4.DOBPr
oof

5.Domi
cil
eDocument

6.Ant
iRaggi
ngdocument(
Fordet
ail
edi
nst
ruct
ions,
got
oannexur
e-I
)

ANNEXURE-I

Itismandat oryt hatallst


udentshav etopr ovi
deAnt iRaggingDeclar
ati
on.Fort
hispur
pose,
kindlyvi
sitthef oll
owingwebsi teforAnt iRaggi
ngf or
m-
ht
tps://www. ant i
raggi
ng.i
n/Site/Affi
davi
ts_Regist
rati
on.aspx
Procedurest obef ol
lowedar e
a)Fillupt hef or
m onl i
ne
b)Thent akepr i
ntout
c) Si
gnt hef ormi nthespacepr ov i
ded
d)Then, takeani mageoft hatsignedAnt iRaggingform andsendit

C.SENDTHECERTIFI
CATE/FI
NALMARKSHEETI
NPDFFORMAT(Onl
y.Pdff
ormatwi
th
200kbi
sal
lowed)

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