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This document is an enrollment form for Satish, a student admitted to the Bachelor of Technology program at the National Institute of Technology Durgapur. It includes personal details, qualifying exam results, payment information, and a declaration by the applicant regarding adherence to institute rules. The admission date is noted as December 10, 2021, and the document is printed on September 4, 2024.

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Satish Kumar Satish
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Download as PDF, TXT or read online on Scribd
6 views

Admissionprint.aspx

This document is an enrollment form for Satish, a student admitted to the Bachelor of Technology program at the National Institute of Technology Durgapur. It includes personal details, qualifying exam results, payment information, and a declaration by the applicant regarding adherence to institute rules. The admission date is noted as December 10, 2021, and the document is printed on September 4, 2024.

Uploaded by

Satish Kumar Satish
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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NATIONAL INSTITUTE OF TECHNOLOGY DURGAPUR

MAHATMA GANDHI AVENUE, DURGAPUR 713209, WEST BENGAL, INDIA


ENROLMENT FORM
PROGRAM : BACHELOR OF TECHNOLOGY

NAME: SATISH Reg. No: 21U10448 Roll No: 21MM8038

Specialization: METALLURGICAL AND MATERIALS ENG Category: SC PwD: NO

Father's Name: DASHAI Gender: M DOB: 02-Mar-2001

Mother's Name: RAJMATI DEVI Nationality: INDIAN Blood Group: O+

Email: [email protected] Contact No.: 8887561804

ID: 210310041817

Qualifying Exam Details:

Degree: 10+2/12th/ Intermediate Status: Year of passing / appearing: 2019

Result preparation mode: CGPA / % Result: 71.80 Qualifying discipline : HINDI ENGLISH PHYSICS CH

Payment Details:

Transaction ID: CPABFDDPO5 Ammount:20000 Date of Payment: 22/11/2021 00:00:00

Permanent Address: VILL KAHLA SIKANDARPUR LALGNJ,Azamgarh,Uttar Pradesh,India-276202

Declaration by the applicant


· I do hereby declare that the information furnished in this application is true to the best of my knowledge and belief and if admitted
I shall abide CPABFDDPO5by the rules and regulations of the Institute and Halls attached to it. If any information furnished in this
application is found to be false, I am liable to forfeit the seat allotted to me and legal action may be taken against me.
· I agree to stay in Hall of Residence and room allotted to me by the authorities and shall abide by the rules of the hall.
· I shall not participate in any move to create group / class feeling amongst the various students. I am aware of the rules regarding
ragging / harassment of juniors as well as the punishments thereof. I undertake that if found guilty of the above I will be liable for
punishment as deemed fit by the authorities. I also understand that I shall cooperate with the authorities in curbing ragging
(including reporting incidents of ragging to authorities), failing which disciplinary action as per rules will be taken against me.
· I clearly understand that under the continuous learning cum evaluation system of the Institute, attendance in classes is
compulsory and that I shall be deregistered from courses on ground of unsatisfactory attendance record.

Date of Print :04/09/2024 Full signature of the Student

Admitted subject to fulfillment of the conditions and requirements at NIT Durgapur.

Date of Admission:10-12-2021 Dean (Academic)

For accessing academic automation software (CHANAKYA) -- User ID: 21U10448 Password:

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