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Visvesvaraya Technological University, Belgaum: Application Form For Photocopy Examination October - 2012

This document contains an application form for a student named Siraj TP from Anjuman Engineering College in Bhatkal, Karnataka, India. The form is for photocopy examination in October 2012 for the subjects Basic Electrical Engineering and Engineering Mathematics - I. It provides the student's details like name, email, subjects applied for, payment receipt details, and contact information. A second similar form is included for re-evaluation examination for the same subjects in October 2012.

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pratik039
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59 views

Visvesvaraya Technological University, Belgaum: Application Form For Photocopy Examination October - 2012

This document contains an application form for a student named Siraj TP from Anjuman Engineering College in Bhatkal, Karnataka, India. The form is for photocopy examination in October 2012 for the subjects Basic Electrical Engineering and Engineering Mathematics - I. It provides the student's details like name, email, subjects applied for, payment receipt details, and contact information. A second similar form is included for re-evaluation examination for the same subjects in October 2012.

Uploaded by

pratik039
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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VISVESVARAYA TECHNOLOGICAL UNIVERSITY, BELGAUM

APPLICATION FORM FOR PHOTOCOPY EXAMINATION OCTOBER - 2012

ACK NO: 1 2 3 4 5 6 7 COLLEGE NAME DEGREE BRANCH UNIVERSITY SEAT NO NAME OF THE CANDIDATE EMAIL ID SUBJECTS APPLIED - 01 Semester Photocopy 10ELE15 - BASIC ELECTRICAL ENGINEERING
Payment Details
: : : : : :

V10202130079

ANJUMAN ENGINEERING COLLEGE, BHATKAL B.E/B.Arch B.E Full Time - Mechanical Engineering 2AB12ME091 SIRAJ TP [email protected]

10MAT11 - ENGINEERING MATHEMATICS - I

Mode of Payment : Cash 8 Fee paid in words Receipt No. with date
: :

Date 25-02-2013 Rupees One Thousand Only


Total Fee Amount (Rs.)

1,000.00

9 Address for correspondence with Phone No: THAYYIL POYYIL PATHRIPPATTA KAKKATIL-673507 KOZIKODE KERALA 9740310336
Date Applied :

Signature of the candidate with date Signature of the Principal/His Representative with college seal

3/14/2013

Signature of the HOD

Page 1 of 2

VISVESVARAYA TECHNOLOGICAL UNIVERSITY, BELGAUM


APPLICATION FORM FOR RE-EVALUATION EXAMINATION OCTOBER - 2012

ACK NO: 1 2 3 4 5 6 7 COLLEGE NAME DEGREE BRANCH UNIVERSITY SEAT NO NAME OF THE CANDIDATE EMAIL ID SUBJECTS APPLIED - 01 Semester Re-Evaluation 10ELE15 - BASIC ELECTRICAL ENGINEERING
Payment Details
: : : : : :

E10203130040

ANJUMAN ENGINEERING COLLEGE, BHATKAL B.E/B.Arch B.E Full Time - Mechanical Engineering 2AB12ME091 SIRAJ TP [email protected]

10MAT11 - ENGINEERING MATHEMATICS - I

Mode of Payment : Cash 8 Fee paid in words Receipt No. with date
: :

Date 14-03-2013 Rupees Eight Hundred Only Penal Fee


Total Fee Amount (Rs.)

0.00 800.00

9 Address for correspondence with Phone No: THAYYIL POYYIL PATHRIPPATTA KAKKATIL-673507 KOZIKODE KERALA 9740310336
Date Applied :

Signature of the candidate with date Signature of the Principal/His Representative with college seal

3/14/2013

Signature of the HOD

Page 2 of 2

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