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Place of Stay During This Semester (Non-Hostellers)

The document is a re-registration form for the 2nd semester of a B.Sc. (Applied Psychology) program for a student named MS Mudra Dave. It includes personal details such as enrollment number, contact information, and addresses, along with a declaration regarding provisional registration and fulfillment of academic requirements. The form also prompts for information on fee payment, hostel accommodation, and any pending evaluations.

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0% found this document useful (0 votes)

8 views2 pages

Place of Stay During This Semester (Non-Hostellers)

The document is a re-registration form for the 2nd semester of a B.Sc. (Applied Psychology) program for a student named MS Mudra Dave. It includes personal details such as enrollment number, contact information, and addresses, along with a declaration regarding provisional registration and fulfillment of academic requirements. The form also prompts for information on fee payment, hostel accommodation, and any pending evaluations.

Uploaded by

Copyright

© All Rights Reserved

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

(RE-REGISTRATION FORM)

Re-Registration for
2
Semester

Enrollment No A210182625001

Name MS MUDRA DAVE

[Link]. (Applied Psychology) (Hons./Hons.

Program
with Research)

Batch 2025-2029

Date of Birth 07/10/2007

E-Mail ID mudradv@[Link]

13,PRIMAL PARK SOCIETY, NEAR DELUXE

CROSSING, NIZAMPURA-390002
Contact Address

VADODARA(Gujarat)

Pin code 390002

Phone 9898903300

Mobile 9898903300

Fax NA

Father's Name NAISHADH DAVE

13,PRIMAL PARK SOCIETY, NEAR DELUXE CROSSING, NIZAMPURA-

390002
Parmanent Address

VADODARA(Gujarat)

Pin code 390002

Phone 9898903300

Fax NA

Place of stay during this Semester (Non-Hostellers)

Address

City

Pin

Telephone

Mobile

E-mail

Hobby Club N/A

Date of payment of fees and fee receipt number : ______________________________

Are You staying in hostel ______________________________ If Yes, Room

No. ______________________________

Are you having any evaluation pending for the previous semester
_____________________________________________

If yes, mention the course(s) and reasons for

it________________________________________________

I understand that my registration for the Semester mentioned above is provisional and it
will stand cancelled in case I do not fulfill the requirements for promotion to the same as
per the academic regulation.I also certify that I do not have any payment of dues and I have
met all academic deadlines till now

Date : _____________________________

(Signature of the Student)

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