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SIDDHARTH UNIVERSITY KAPILVASTU, SIDDHARTH NAGAR

Campus Admission Form : 2023-24


M.B.A. III Semester (NEP)
REGULAR

FORM NO. 23510214


ROLL. NO. 23101902110010
ENROLL. NO. SUK101230695

CANDIDATE'S NAME: ABHISHEK PATHAK

FATHER'S NAME: REETA PATHAK

MOTHER'S NAME : SANTOSH PATHAK

GENDER: MALE

DATE OF BIRTH: 10 FEB 2003

CATEGORY : GEN

NATIONALITY: INDIAN

ADHAR NO.: 309627536554

ADDRESS : VILL GAURI PATHAK POST JHAHRAW

DISTRICT : SIDDHARTHNAGAR

STATE: U. P.
Paste photograph as
same uploaded on
PIN CODE: 272189 portal

MOBILE NO.: 8707085509


EMAIL ID : ABHISHEKPATHAK87070@GMAIL.COM

RELIGION: HINDU

FEE : 3219
TRANSACTION ID : 4514769926415
TRANSACTION
24/08/2023 13:58:34
DATE :

DECLARATION
I DECLARE THAT ALL ENTRIES IN THIS FORM HAVE BEEN FILLED BY ME. I FURTHER AFFIRM THAT, I SHALL
NOT MAKE ANY REQUEST FOR CHANGE IN FUTURE. I ALSO DECLARE THAT NO CRIMINAL FIR HAS BEEN
LODGED AGAINST ME AND IF ANY FIR FOUND IN FUTURE TOO, MY ADMISSION SHALL BE CANCELLED. I
SOLEMNLY DECLARE THAT THE INFORMATION GIVEN IN THE FORM IS TRUE TO THE BEST OF MY
KNOWLEDGE. I PROMISE THAT DURING THE PERIOD OF MY STUDY, I SHALL ABIDE BY.

(SIGNATURE OF APPLICANT)

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