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| Registration
Form |
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| Personal Information |
| University Roll No
|
|
College No
|
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| Name
|
|
Registration Date |
|
<%--
--%>
|
| Father's Name |
|
Occupation |
Doctor
Bussiness Man
Advocate
other
|
|
|
|
| Mother's Name |
|
Occupation |
House Wife
Working
|
|
|
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| D.O.B. |
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Gender |
Male
Female
|
|
|
|
| Yearly Income(Rs) |
|
Physically Handicapped |
No
Partial
Full
|
|
|
|
| Email |
|
Blood Group |
A-
A+
B-
B+
AB-
AB+
O-
O+
|
Category |
SC/ST
GENERAL
OBC
|
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| Identification mark |
|
Permanent
Address |
|
Present
Address |
|
Address For
Correspondence |
|
|
| Academic Qualification |
| High
School | Board/University |
|
Passing Year |
1998-99
1999-00
2000-01
2001-02
2002-03
2003-04
2004-05
2005-06
2006-07
2007-08
2008-09
2009-10
2010-11
2011-12
2012-13
2013-14
2014-15
2015-16
2016-17
|
Percent |
|
Div |
I
II
| |
|
Intermediate | Board/University |
|
Passing Year |
1998-99
1999-00
2000-01
2001-02
2002-03
2003-04
2004-05
2005-06
2006-07
2007-08
2008-09
2009-10
2010-11
2011-12
2012-13
2013-14
2014-15
2015-16
2016-17
|
Percent |
|
Div |
I
II
| |
|
Diploma In |
| Board/Institute |
|
Passing Year |
1998-99
1999-00
2000-01
2001-02
2002-03
2003-04
2004-05
2005-06
2006-07
2007-08
2008-09
2009-10
2010-11
2011-12
2012-13
2013-14
2014-15
2015-16
2016-17
|
Percent |
|
Div |
I
II
| |
|
Graduation In |
| University |
|
Passing Year |
1998-99
1999-00
2000-01
2001-02
2002-03
2003-04
2004-05
2005-06
2006-07
2007-08
2008-09
2009-10
2010-11
2011-12
2012-13
2013-14
2014-15
2015-16
2016-17
|
Percent |
|
Div |
I
II
| |
| P.G.
In |
|
University |
|
Passing Year |
1998-99
1999-00
2000-01
2001-02
2002-03
2003-04
2004-05
2005-06
2006-07
2007-08
2008-09
2009-10
2010-11
2011-12
2012-13
2013-14
2014-15
2015-16
2016-17
|
Percent |
|
Div |
I
II
| |
|
|
Admitted in - - - Professional Course |
| Admitted In |
Session |
2005-06
2006-07
2007-08
2008-09
2009-10
2010-11
2011-12
2012-13
|
Course |
B.TECH
MBA
|
Branch |
|
Sem |
|
College |
ACET
ACMT
| |
| Currently Studying In |
Session |
2011-12
|
Course |
B.TECH
MBA
|
Branch |
|
Sem |
|
|
| |
|
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Contact Details |
| Own Mobile No. |
| Father's Mobile No. |
| Phone-1 (Res) |
| |
| |
| Emergency | Contact Person |
|
| Phone-2 (Res) |
| | | |
|
Name |
Relation |
Mobile No. |
E-mail | | | | | |
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Fee Details |
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Additionally Opted For :- | |
| |
| |
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| Route |
Delhi
Ghaziabad
Modinagar
Meerut
Baraut
| Halt |
| |
|
|
Scholarship/Fee-reimbursement
from Samaj Kalyan during current session |
| Amount(Rs.) |
| |
|
|
Applicable
TOTAL DUES during current session |
|
Education Loan |
| |
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| FINE Details |
| Library(Rs.) |
| |
| Admin(Rs.) |
| |
| Late Registration(Rs.) |
| |
|
| Fee Dues Status |
| Total Dues with Fine |
| To receive from Samaj Kalyan/others |
| Min amount to be paid by student |
| |
|
| Fee Deposition |
| Now Paying Amount(Rs.) |
| Mode of Payment (Details) |
| |
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| Payment-1 |
| Receipt No. |
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| |
| Payment-2 |
| Receipt No. |
| | | |
| Payment-3 |
| Receipt No. |
| | | |
| Total Deposition |
| | |
| | |
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|
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Permitted for partial fee deposition |
| Amount(Rs.) |
| |
|
|
|
Total |
|
Samaj Kalyan/others |
|
Student |
| |
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Upload Photo & Signature |
| Photo Upload |
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| Sign Upload |
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