BPT Semester 3 Re-Registration Form

This document is a re-registration form for a student named Deepak Kumar, enrolled in the BPT program for the 2024-2028 batch. It includes personal details such as contact information, father's name, and addresses, along with a declaration regarding provisional registration and academic requirements. The form also prompts for information about fees, hostel accommodation, and any pending evaluations.

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natwadiarahul

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BPT Semester 3 Re-Registration Form

Uploaded by

natwadiarahul

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
3
Semester
Enrollment No A22906624013
Name MR DEEPAK KUMAR
Program BPT
Batch 2024-2028
Date of Birth 19/07/2004
E-Mail ID deepkumar19072004@[Link]
TEH DANTARAMGARH, SHYAMPURA ,SIKAR
Contact Address
SIKAR(Rajasthan)
Pin code 332403
Phone 7357602080
Mobile 7357602080
Fax NA
Father's Name SURENDRA KUMAR
TEH DANTARAMGARH, SHYAMPURA ,SIKAR
Parmanent Address
SIKAR(Rajasthan)
Pin code 332403
Phone 7357602080
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)
((Name & Signature of the Verifying Faculty))

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BPT Semester 3 Re-Registration Form

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BPT Semester 3 Re-Registration Form

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(RE-REGISTRATION FORM)

Date of payment of fees and fee receipt number : ______________________________

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