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(RE-REGISTRATION FORM)
Re-Registration
2
for Semester
Enrollment No A2180222007
Name MS G K ROSHINI MOHAN
Program M.I.D.
Batch 2022-2024
Date of Birth 14/01/1992
E-Mail ID NA
D.NO:27, FLAT B, PLOTNO:1161, 17 TH STREET,
ANNA NAGAR WEST END COLONY, ANNA NAGAR
Contact Address WESTERN EXTENSION,

CHENNAI [MADRAS](Tamil Nadu)

Pin code 600050
Phone 9677035760
Mobile NA
Fax NA
Father's Name G R KRISHNA MOHAN
D.NO:27, FLAT B, PLOTNO:1161, 17 TH STREET, ANNA NAGAR WEST END
COLONY, ANNA NAGAR WESTERN EXTENSION, ANNA NAGAR WESTERN
Parmanent
EXTENSION,
Address
CHENNAI [MADRAS](Tamil Nadu)
Pin code 600050
Phone 9677035760
Fax NA
Place of stay during this Semester (Non-Hostellers) In Rented Accommodation
Address b5/007 klassic block B JAYPEE WISHTOWN
City noida
Pin 201304
Telephone 9677035760
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 Re-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 AUUP Regulations
(Regulation No-1 on subject Conduct of Examinations, Scheme of Evaluation and Discipline among
Students in Examinations).I also certify that I do not have any payment due to AUUP and I have met all
academic requirements till now.I shall abide by all rules and regulations of Amity University as per my
undertaking in registration form.
I have also thoroughly read and understood the Policy Guidelines for Information Security. I understand the

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1/30/23, 12:03 PM DIV Contents

contents, and I agree to comply with the said Policy.I further understand that should I commit any violation
of this policy, my access privileges may be revoked and disciplinary action and / or appropriate legal action
may also be taken against me.
Date : _____________________________
(Signature of the Student)
((Name & Signature of the Verifying Faculty))

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