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Students Identity-Card Form

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61 views

Students Identity-Card Form

Uploaded by

singhakanksha32645
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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CSJM UNIVERSITY, KANPUR

REGISTRATION FORM Fix your Latest


Passport Size
FOR Photograph

Student Identity Card


Personal Information :-
(USE CAPITAL LETTERS ONLY)
Surname : …………………….……………………………….. Forename : …………….……...
…………………………….

Email. : ……………………………………….. Department. : ……………………..…. Course. : ………………………….

Father’s Name : …………..…………………….……………………… Mobile No. : …………………………………….


…

Local Guardian Name. : ………………….


……………………………………………………………………………………

Mobile No. : ……………………………………..… Email. : ………...


………………………………………………………

DOB. : ..…….…………………………………… Year of Session / Batch :


………………………………………………….
Gender : M/F/T : …………….. Blood Group :………...…. Aadhaar No. (Enclosed Copy). : ……...
…………………………
Contact Information :-
Permanent Address. :
……………………………………………………………………………………………….
………………………………………………………… City. : …………………………... Pin. :
…………………

Local Address. :
…………………………………………………………………………………………………….

………………………………………………………… City. : …………………………... Pin. :


…………………

Student Contact No. : ………..……………..………… Emergency No. : ….………………………………….….

Email ID. : ………………………………………………………………………………………………………….


Declaration and Undersigned : - The undersigned would like to Applied for library membership. I am aware of
undertake to abide by the copyright act 1986 and amendments. I will update to library of any change in my contact details.
I agree to observe the library rules.

Date :- (Student Signature)


The Photograph and details furnished by student is verified and found correct as per official records of
Department/Institute. He/She has deposited the course fees for the current session ……………………………….
………………………………….

Seal of Dept/Institute (Signature of HOD)

For Central Library Official use only :


Library ID. : ….………………………………………….. Issued No. : ………….…..
……………………………
Valid Upto. : ………………………………….…………………………………………………………………….

(Staff Signature)

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