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REQUISITION 'FOR PROJECT WORK IN APSRT'RC

(Notification No'-PD-D5/2017, Dt.14.06.2,017) PHOTO

LName of the Student I.

2.Father's Name

3.QuaJJJicaticm details:
a) Name of 'the College studying &
Address

b) Name of the Course studying


(eg:Bg,/B.Te,ch/MEA etc.j)
c) Regd . No./RoU No. in College
d] Year of stud~
e) Institute I.D. subrnitted'(Yes/No)
4.Mobile No.
5.. Project work details:
a) Topic

b) Preferred place to do Project work


c] Duration ()f Project work
, 6.Fee particulars:
a) Amount
b) MJZ.No. & Date
7. Is your Father/Mother working in
APSRTC (Yes/No):
a) If yes". indicate Name

b) Staff No.
cl Design.
d) Unit
e) Letter submitted from Unit
OfficerfYe s./No r I
I 8. Requisition letter from the College
Principal/HOD/Guide
endosed(Yes/No)
9. Email address of the student
'.

lO.Aadhar No.of the student

Date: SIGNATURE OF THE STUDENT

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