EXAMINATION FORM FOR EXAMINATION: May-2012

For Re-appear Semester Only

Institute Branch Roll No / Name Father / Mother Name Mobile / Email / Batch CGC- Faculty of Engineering, Gharuan, Mohali B.Tech.(Mechanical Engineering) 1140336/Om Parkash Dalip Kumar/Indra devi 9855946891/gauravkhanna123@gmail.com/2011 Subjects in which appearing Subject Code / Paper Id Semester 1 BTAM-101 / A1101 BTCS-101 / A1108 BTME-101 / A1107 Engineering Mathematics-I /Chemistry Group (2011 Batch) / Chemistry Group (2011 Batch) Fundamentals of ComputerProgramming and IT /Chemistry Group (2011 Batch) / Chemistry Group (2011 Batch) Elements of MechanicalEngineering/Chemistry Group (2011 Batch) / Chemistry Group (2011 Batch) Subject Title / Remarks

Entry Date :-29 Mar 2012

Affix photograph to be attested by principal/ Competent Authority

T/P

Internal

External

Theory Theory Theory

No No No

Yes Yes Yes

I have understood all the regulations and its amendments in regard to examinations. I found myself Eligible to appear in Examination. In case University declare me ineligible due to any wrong information submitted in examination form by me, I shall be responsible for the consequences at any stage.

Sign of Candidate ________________________

Sign with ball pen __________

Date___________________

Certified that the Candidate has completed the prescribed course of study and fulfilled all the conditions laid down in the Regulations for the examination and is eligible to appear in the examination as a regular / ex-student of Punjab Technical University, Jalandhar. The candidate bears a good moral character and particulars filled by him/her are correct.

Signature of the Principal / Competent Authority (With Seal and Date) ________________________

(Signature of HOD)

Receipt of Re-appear Examination Form and Examination Fee for Examination May-2012 Received Re-appear Examination Form and Examination Fee of Rs._________________ and late fee (if any) Rs. ___________ from Student Name: Om Parkash and Student RollNo: 1140336. Signature of Institute Dealing Head with seal