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This document is a re-registration form for a student named Mr. Saklen Babar Khan, enrolled in the B.Tech (CSE) program for the 2025-2029 batch. It includes personal details, contact information, and addresses, along with a declaration regarding provisional registration and academic compliance. The form also prompts for fee payment details and any pending evaluations from the previous semester.

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5 views2 pages

DIV Contents

This document is a re-registration form for a student named Mr. Saklen Babar Khan, enrolled in the B.Tech (CSE) program for the 2025-2029 batch. It includes personal details, contact information, and addresses, along with a declaration regarding provisional registration and academic compliance. The form also prompts for fee payment details and any pending evaluations from the previous semester.

Uploaded by

sk143190001
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 A35705225167
Name MR SAKLEN BABAR KHAN
Program [Link] (CSE)
Batch 2025-2029
Date of Birth 08/08/2007
E-Mail ID NA
TENGRA JAM TOLI, BASIA, OKBA,
MAMARLA
Contact Address
GUMLA(Jharkhand)
Pin code 835229
Phone 8434001949
Mobile NA
Fax NA
Father's Name JABAAR KHAN
TENGRA JAM TOLI, BASIA, OKBA, MAMARLA
Parmanent Address
GUMLA(Jharkhand)
Pin code 835229
Phone 8434001949
Fax NA
Place of stay during this Semester (Non-Hostellers) In PG Accommodation
Address 1 near railways crossing nayasarai
City ranchi
Pin 835303
Telephone 7979778927
Mobile
E-mail

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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