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Wifi Mutaiyab

The document is an ICT request form for the academic session 2024-25 at Aligarh Muslim University, filled out by a student named Mohd Mutaiyab Alam. It includes personal details, an undertaking regarding the responsible use of university ICT facilities, and instructions for submission. The form also requires certification from the provost and the student's department confirming their status and dues clearance.

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emadahmed5202
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9 views1 page

Wifi Mutaiyab

The document is an ICT request form for the academic session 2024-25 at Aligarh Muslim University, filled out by a student named Mohd Mutaiyab Alam. It includes personal details, an undertaking regarding the responsible use of university ICT facilities, and instructions for submission. The form also requires certification from the provost and the student's department confirming their status and dues clearance.

Uploaded by

emadahmed5202
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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8/24/24, 7:53 PM about:blank

PROF. M. N. FAROOQUI COMPUTER CENTRE


ALIGARH MUSLIM UNIVERSITY
ICT REQUEST FORM FOR ACADEMIC SESSION: 2024-25
D NO: ............ CONTINUATION DATED: .............
Hall of Residence: Sir Affix
Enrollment: GI7210
Sulaiman Hall
Faculty Number: 20BMMEA103 Hostel: Not Allotted
(do not staple)
Full Name: MOHD MUTAIYAB ALAM Room No: 0 recent
Date of Birth: NOV 10, 1999 Photograph
Permanent Address: VILL AND 2.5cm x 3cm
POST- shiv tara
Father's Name: ARSHAD ALAM Ambedkar Nagar-224129 duly attested by
Uttar Pradesh the Provost
India
Mother's Name: NASREEN BANO
Course Type: PG
Course Name: M.Tech. (Bio-Medical Engineering)
Department: CENTRE FOR INTERDISCIPLINARY BIOMEDICAL
AND HUMAN FACTORS ENGINEERING
UNDERTAKING BY THE APPLICANT
I, mohd mutaiyab alam hereby declare that:
I understand that University ICT facilities, meant for Academic/Research support are shared resources, being extended to me
for reasonable and bonafide usage only.
I understand that I am solely responsible to protect my Login Credentials and would like to confirm that the same shall
neither be revealed to anybody nor it shall be used to support any unethical/illegal activity.
In case of misuse, my University ICT credentials may be blocked/suspended/withdrawn without any intimation. The
university may take disciplinary actions against me as deemed fit by the university.
I shall personally ensure to surrender my University ICT Credentials and acquire No-Dues, prior to my leaving the University.
I am aware that University may implement Quota/Ceiling-Flooring Limits, limited timings for availability of service and
support of various ICT Services. The same is unconditionally acceptable to undersigned.
I am aware that information furnished by me shall be subject to relevant provisions of IT Act 2000 and its subsequent
amendments as applicable from time to time.
I am aware that any action or communication, spoken or written or by photo images done using my University ICT
Credentials, may be attributed to me, even if it has been done using my University ICT Credentials without my consent or
authorization. Consequently, I shall take all relevant precautions needed on my part from time-to-time to protect my
University ICT Credentials against misuse.
I shall use my University ICT Credentials as per the policies, procedures and rules maintained by University from time to time.
I have read, understood and accepted all the aforesaid terms and conditions and I am also enclosing my University ID card
(valid for minimum 6 months) in support of my request for University ICT services.
I hereby certify that, the all of my information furnished above is correct to the best of my knowledge and belief & nothing is
falsified

____________________
Signature of the student

IMPORTANT NOTE:
1. It is mandatory on the part of students to send this registration page to Shift-Incharge(on duty) at PROF. M. N. FAROOQUI COMPUTER CENTRE, AMU
through University DAK with original signature(s), photograph attestation and endorsement by provost & department concerned.
2. Students should also retain a photo copy of the registration form for their own records.
3. Incorrect, incomplete and applications not received through University DAK shall be considered invalid for processing.
4. It may take upto 5 working days for processing of valid application forms at PMNFCC, after receipt through University DAK only.

CERTIFICATE FROM DEPARTMENT, CENTRE FOR


CERTIFICATE FROM PROVOST, SIR SULAIMAN HALL INTERDISCIPLINARY BIOMEDICAL AND HUMAN FACTORS
ENGINEERING
The candidate is/was a regular member of this Hall during
The entries made above are correct and as per rules, to the
the current session (2024-25) and his/her Hall dues is clear
best of my knowledge.
as on date.
Signature (with seal) _______________
Signature (with seal) _______________
(Dean / Principal / Chairperson / Coordinator / Director)
(Provost)
Dated: _______________
Dated: _______________

gi7210
R NO: _________/CC Dated:_______________ Printed at: Sat Aug 24 20:03:26 IST 2024

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