I.K.
GUJRAL PUNJAB TECHNICAL UNIVERSITY
MAIN CAMPUS, KAPURTHALA
VPO - IBBAN, JALANDHAR-KAPURTHALA HIGHWAY, KAPURTHALA-144603
(REGISTRATION FORM FOR SESSION_________)
1. Name of the Student:___________________________ Fix your Passport
2. University Roll Number:_____________________ Size Coloured
3. Course Name:______________________________ Photograph here
4. Semester:__________________________________
5. Mobile Number:_________________________
6. Contact Number of Parents: 1._____________________ 2. _____________________________
7. Is there any pending UMC case against you? Yes/No (Tick one). If yes, attach details.
SUBJECTS TO BE REGISTERED IN THE CURRENT SEMESTER
Sr. No. Subjects Registered Code of Subject L T P Credits Signature of Subject
Teacher
Total Credits registered by the student in the semester: ____________
STATUS OF EARLIER EXAMINATIONS
Semester If passed in all subjects, then year If not fully passed, then number of % of Marks/ SGPA
of Exam Backlogs
I
II
III
IV
V
VI
VII
FEE PAYMENT STATUS
Sr. No. Type of Fee Details Of Fees Paid (in Rs.) Balance Fee yet to be Remarks
Date of Receipt no. Amount paid in Rupees as on (Not To Be Filled By The
(Academic/Hostel)
Student)
Payment Paid this Date
DECLARATION BY THE STUDENT
I have checked that the Registration form is completely filled. All the information filled by me in registration form is correct.
I have attached the following documents (Tick appropriate) with the Registration form:
(i) Copy of Fee Voucher/Fee Receipt (ii) Receipt of late fee, if applicable
(ii) Anti-ragging affidavits by the student and his/her parents separately in prescribed performa (iv) Copy of receipt of payment of pending dues
(v) UMC case details, if applicable (vi) Hostel fee receipt
Date: Signature of the Student
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Check List for student registering in Even Semester:
To be filled by Competent Official
(Tick the Appropriate boxes)
Registration Date
All Documents attached Yes No
Registration Form has been filled and signed by Yes No
student and concerned course instructor
Payment of semester fee is done. Receipt No. Yes No
entered in Registration form
In case of fee is not paid/ pending give reasons: PMS
BSCS
Other Education Loans
Relaxation in fee approved by the competent authority
Any other reasons:
Late Registration Fine Payment Status Not Paid Pending
Applicable
Amount (in Rs.):
Fee Receipt No.:
Date:
Registration Status Registered Registered Provisionally Not Registered
Fee Category of EWS Tuition Fee SC/ST/Post Matric/ General Fee
Student Waiver Any other
Classes are scheduled as per time table. Yes No
There are no classes unassigned. Yes No
All labs sessions are held as scheduled in time Yes No
table.
The above is verified by :
Name of Competent Official :
Signature of Competent Official :
Date :
Approved /Not Approved by:
Signature & Stamp of
Head of the Department
Date:
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