Veer Madho Singh Bhandari Uttarakhand Technical University, Dehradun

A State Government University Established By Uttarakhand State Government

Vide Act No.415 of 2005
ACADEMIC REGISTRATION & ENROLMENT FORM : 2022-23

Personal Details
Registration No. : ST0000015881
Application No. : AP220000009830
College Code : 119
College Name : SEEMANT INST. OF TECHNOLOGY PITHORAGARH
Course Name : B.TECH
Branch Name : Computer Science & Engineering
Semester / Year : 5 Semester
Student's Name : GURMEET SINGH
Father's Name : Satveer Singh
Mother's Name : Meena Devi
Date of Birth : 10/05/2001
Gender : Male
Identification Marks : Mole on Chest
Fee Category : False
Aadhar Card No. : 459213396566 Category : GEN
Religion : Hindu Sub Category : None
Admission Mode : N/A Nationality : Indian
Year of Admission : 2020 Country : N/A
Admission Quota : N/A State : Uttar Pradesh
Driving Licence No. : N/A District : Amroha
PAN No. : N/A Pin Code : 244221
Student's Email ID : gurmeetsingh201920@gmail.com Father's Mobile : 8958583789
Student's Mobile No. : 7240642756 Digilocker ID : gurmeetsingh201920
Student's other Mobile No.: 9058065852 Academic : 717373583175
Blood Group : AB+ Bank Credit ID
Address : Sultanpur Intazam Alikhan, Amroha, Uttar Pradesh, 244221

Qualification Details

Name of Exam Board/University Year Roll No Max Mark Obt. Mark Percentage
10th Board of High School and 2016 0834049 600 484 80.67
Intermediate Education U. P.
12th Board of High School and 2018 0670232 500 342 68.40
Intermediate Education U. P.
Fees Details

Registration Fees (Rs) Enrolment Fees (Rs) Total Fees (Rs)

0.00 0.00 0.00
NOTE:-Attested Photocopy of Marks sheet of Qualifying Examination (i.e. Intermediate,Graduation Post Graduation etc.) and other
relevant documents, must be attached with enrolment form.

DECLARATION BY CANDIDATE
1. I have read the rules in the relevant Ordinances applicable to me and undertake to abide by them and will not claim any benefit out
of some error or mistake on the part of the University, which is not allowed under the ordinances.
2. I hereby declare that the entries in the form are true to the best of my knowledge and belief, in case any entry in this form is found
to be false. I will have no objection if theUniversity disqualifies me from appearing in examination/cancels my registration or
debars me from appearing in the Examination in future.

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 Veer Madho Singh Bhandari Uttarakhand Technical University, Dehradun
A State Government University Established By Uttarakhand State Government
Vide Act No.415 of 2005
ACADEMIC REGISTRATION & ENROLMENT FORM : 2022-23
3. I, hereby declare that I shall not indulge in any act of indiscipline in Institution and University
4. I hereby declare that I shall not be involving myself in any act that affects the dignity of any one.
5. I'm fully aware that the desired details of Digilocker/ABC ID/Aadhaar, if not submitted here, will have to be submitted by January
31, 2023. The registration/enrolment will remain provisional till submission of complete details & University will take necessary action
as deemed suitable and withald the examination result due to any discrepancy.

NOTE:-Those candidates who have been punished earlier for any reason are required to enclose the punishment order

Date: 12/12/2022
Signature of Candidate
CERTIFICATE BY THE HEAD OF THE INSTITUTION

· The entries made by the candidate in this Enrolment form have been checked and verified by the institute and are
certified to be correct and candidate is found eligible to be permitted for Enrolment in the University.The candidate has
deposited the requisite Examination and Enrolment Fee as prescribed by University.
· It is also certified that the said student has been admitted to the concerned programme within the he approved admission
capacity, prescribed by the University.
· It is undertaken that in case of this admission being beyond the prescribed intake capacity of programme and is found to
be violating the admission norms of the University, The University may cancel the admission
for which no claim shall be made by the Institution and student.

Date :_______________ Signature: _________________________

Place:___________________ Name of Head of Institution: _________________

Office Seal: _________________

NOTE:-
(1) Principal/Director should sign. himself on the above certificate and in no case facsimile stamp should be used.
(2) The attached photocopy of all the certificates & marksheet must be attested by Director/Principal Dean of Institute with
official Seal.

ENDORSEMENT BY UNIVERSITY
The candidate is enrolled in the university, however the university reserves right to cancel the enrolment in case of any
information found incorrect/misconduct or any unforeseen situation, in which university decides to do so.

Registrar
VMSBUTU, Dehradun

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