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(Application ID)
The Registrar, West Bengal University of Technology BF-142, Saltlake, Sector-1 Kolkata-700064, West Bengal
Sir, I hereby apply for registration as a student of West Bengal University of Technology. A sum of Rs. 400/- is remitted herewith as Registration Fee for the academic session 2013-2014. Necessary particulars relating to myself, given below, are true to the best of my knowledge. Place:_______________ Date: _______________ Signature of Applicant (Please Sign within the box)
Registration applied for : Not Available Roll No. (if Re-Admission / Branch Change): Registration No. (if Re-Admission / Branch Change): Session Year : Degree : Not Available Registration Against : Enrollment No: () Name : Rank & Category : (), () College Name : Not Available Course : Not Available Applying for concession : NA
Sex: Unknown Category: Physically Challenged: Date of Birth: -Nationality : Religion : Father's Name : Mother's Name : Address1 : Address2 : PINPhone: Email: Guardian's Name : Address1 : Address2 : PINName of School/College or University of which he/she was a student prior to this admission:-
Submission Date:
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Student Name : (Application ID : ) Name of College/Institution where you have been admitted :_________________________________________________________________________________________ The particulars mentioned in page 1 of registration form are true to the best of my knowledge. I shall abide by the rules & regulations of the West Bengal University of Technology. _________________________________________ Full Signature of student with date. Checked and Forwarded by __________________________________________ Signature of Director / Principal / Teacher-in-charge Name of College/Institution ____________________ __________________________________________ College Code _______________________________ Date: ______________ Place __________________ _________________________________________ Full Signature of Guardian with date
Seal ________________________________