National service scheme(nss)

and
msu pharmacy alumni association
SELF DEFENCE CAMP 2019
REGISTRATION FORM Sr.no.

NAME______________________________________________________________

FACULTY _____________________ DEPARTMENT______________________

YEAR __________________________PHONE ____________________________

CURRENT ADDRESS_________________________________________________

EMAIL ____________________________________________________________

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Sr.no.

NAME _____________________________________________________________

FACULTY ________________________DEPARTMENT ____________________

VENUE – CEMENT PARKING, FACULTY OF TECHNOLOGY &

ENGINEERING, MSU BARODA KALABHAVAN .

DATE – 9th & 10 th FEBRUARY, 2019 TIME- 7 A.M TO 10 A.M

ENTRY FEE – Rs. 30/-

IT IS COMPULSORY TO PRESENT THIS FORM BEFORE THE CAMP.

For further details contact

Chintan Langaliya : 7405237473