OFFICE OF THE PRINCIPAL

HIGHER AND TECHNICAL INSTITUTE, MIZORAM

KAWMZAWL, PUKPUI, LUNGLEI: 796 691, MIZORAM
Romans 11:36 E-mail: hatimoffice@gmail.com
MOTTO: SEEK, SHARE, SERVE Phone: 8787808163

MIZORAM UNIVERSITY EXAMINATIONS EVEN 2021

OFFLINE ONLINE

APPLICATION FORM

NAME (in block letters): ____________________________________________

FATHER’S NAME : ____________________________________________
COURSE : B.A. B.COM BCA BSW
SEMESTER :I II III IV V VI
ROLL NO : ______________________________________
REGISTRATION NO : ______________________________________
ADHAAR NO : ______________________________________
AMOUNT OF FEES : Rs. ___________________________________
(Rupees _________________________________________________________ only)

SUBJECT(S)/PAPER(S) IN WHICH HE/SHE DESIRES TO BE EXAMINED:

Sl.
Course Code Subject
No.
1
2
3
4
5
6
7

PRACTICAL PAPER(S) (if any):

Sl.
Course Code Subject
No.
1
2
3

__________________________
Signature of the Candidate

Note: Document(s) not required.