Vous êtes sur la page 1sur 2

Thanks for submitting your Application

Form2016024947748which can be used for all


future correspondence
Amount: 250
Payment Transaction No: PHMP6936799981

Examination Form View Form PDF

Personal Details

Student's Enrollment No. : AO5876

Student's Roll No. : 2242413007

Student's Name : AMIT HANSDA

Social Category : UR

Gender : Male

Mobile Number : 8109351232

Email Id : amith328@gmail.com

Academic Details

College Name : J K Institute of College code : 024

Engineering,Bilaspur
Program Name : Diploma Year/Semester : SEMESTER 6

Course Name : Dip. in Electrical Engg Course Code : 2024

Exam Type : Backlog Applying Year/Semester : 3

Subject Details

Sl. No. Subject Name Subject Code

Fee Details

Total Fee(in Rupees) : 250 /-

Payment Transaction No : PHMP6936799981

Payment Date : 27/Nov/2018

Declaration By Student
I hereby declare that:
1. I certify that this application has been filled by me and the information given therein is correct.
2. I also certify that I am enrolled only in above program/course of Chhattisgarh swami Vivekanand Technical University, Bhilai (C.G.).
3. I further declare that I am neither enrolled as a regular student in any other educational institute nor appearing in any other examination
as a regular candidate.
4. I understand that if it is found that the information furnished above is false then my result of examination will be cancelled.
5. I accept to abide by all the rules and regulation of study and examination as prescribed by Chhattisgarh Swami Vivekanand Technical
University, Bhilai (C.G.).

Signature of Applicant

Declaration By Principal

I hereby declare that:


1. The entries in the application form have been examined and verified properly and found correct.
2. The candidate is eligible to appear in the examination as per rules of Chhattisgarh Swami Vivekanand Technical University, Bhilai (C.G.).
3. The aforesaid candidate is not debarred from appearing at the above examination.

Signature of Principal
Version 13.05.01

View Form PDF

Please click here to download your form. .