NPTEL COURSE ENROLLMENT

STUDENT DETAILS
Name of the student
(In BLOCK letter)

Program B.Tech. / MCA / MSc.

SIC No. Regn. No.

Branch Semester Section

Name of the course enrolled

Duration of the course …… weeks Start Date End Date

Exam Registration Completed / Not completed

Proof of enrolment and exam registration submitted Yes No

Signature of the student

VERIFICATION BY BRANCH COORDINATOR

Course 1 Enrolled from the approved List Yes No

Course 1 Enrolled from the approved List Yes No

Proof of Enrollment submitted Yes No

Proof of Examination Registration details submitted Yes No

Any other Remarks :

Verified by the Branch Coordinator Verified by the Faculty Coordinator