osi0ar2020 ‘Admission Form Kasegaon Education Society's (An Autonomous Institute) RAJARAMBAPU INSTITUTE OF TECHNOLOGY, RAJARAMNAGAR APPLICATION FORM FOR THE ADMISSION TO THE HIGHER CLASSES DEGREE Admission For : Third Year B.Tech, Information Technology (2020-2021) To, The Director, Rajarambapu Institute of Technology, Rajaramnagar. Sir / Madam, I wish to take the admission in the college for higher class. The details are given below. I may please be given admission to the college. I have gone through the rules and regulation of institute and i hereby agree to abide by the rules and regulations. Name PATIL SHUBHAM SHANKAR Date of Birth 05/06/2000 Blood Group Unknown Gender MALE Religion/Cast Category Mobile No. 7620822655 Email ld shubhampatilsjune@gmail.com Adhar Card No. 314145625874 ‘AT: DHAVALI, TAL- WALWA, DIST- OPEN Local Address Permanent Address MobNo./Ph.No.(With STD) Parent or Guardian's Name Relation with Guardian Last Attended Class Year Amount Paid Paid Through Bank Date of Application: Admitted To ADMISSION INCHARGE SANGLI ‘AT: DHAVALI, TAL- WALWA, DIST- SANGLI 9673568110 PATIL SHANKAR GANPATI SON Second Year B.Tech. 2019-2020 10000 ONLINE ICICI bank Dhavalt 05/09/2020 Taluka: WALWA Dist: SANGLI MAHARASHTRA,INDIA 416302 ‘Taluka: WALWA Dist: SANGLI MAHARASHTRA,INDIA 416302 Roll No, 1804066 ‘Transaction/DD/Challan No, CICAgKCL_7TIHA, Transaction Date 05/09/2020 Signature of Student FOR OFFICE USE ONLY REGISTRAR 1210.212.171.172/R17OficeNew/Studenttr_NextYaarAdmissionPrint.aspx Roll No, PRIN. DIRECTOR "