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Application Number:: (Autonomous Institute Under VTU, Belgaum and UGC, New Delhi)

This document is an application form for Prashanth M to take the January 2013 semester examinations. It lists the 8 subjects he is enrolled in, confirms he has no backlog subjects, and provides his contact information. It also includes a certificate from his department head and principal confirming his student status and eligibility to take the exams pending satisfaction of attendance and other requirements. Instructions remind the candidate to verify details, sign, and report any discrepancies.

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Prashanth M Prashu
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33 views1 page

Application Number:: (Autonomous Institute Under VTU, Belgaum and UGC, New Delhi)

This document is an application form for Prashanth M to take the January 2013 semester examinations. It lists the 8 subjects he is enrolled in, confirms he has no backlog subjects, and provides his contact information. It also includes a certificate from his department head and principal confirming his student status and eligibility to take the exams pending satisfaction of attendance and other requirements. Instructions remind the candidate to verify details, sign, and report any discrepancies.

Uploaded by

Prashanth M Prashu
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
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PES INSTITUTE OF TECHNOLOGY

( Autonomous Institute under VTU, Belgaum and UGC, New Delhi )


Application Number : 2012/O/08024 Semester: Fifth Program : B.E.
APPLICATION FORM FOR SEE : JANUARY, 2013
USN : 1PI10ME079 Name of the Candidate : Prashanth M
ENROLLED SUBJECTS :
1. 10ME301 Design of Machine Elements - I
2. 10ME302 Mechanics of Machines and Mechanisms
3. 10ME303 Heat Transfer
4. 10ME304 CAD / CAM
5. 10ME305 Metal Forming Process
6. 10ME306 Thermodynamics and IC Laboratory
7. 10ME307 Fluid and Machines Laboratory
8. 10ME308 Measurement and Metrology Laboratory
BACKLOG SUBJECTS: Nil
Any Other Subjects, Please Specify
Total Fee paid ( in words )
Challan/Receipt No. with date
Regular Fee:
1060
Penal Fee:
Total Fee:
Are you exempted from payment of fees
Yes No
SC ST Category-1
If yes, please Tick
[ Documentary evidence to be provided ]
Address for correspondence with phone number:
Prashanth M, C/o, Mr.Mruthyunjaya N
,# 44, 3rd 'A' Main, ,Iyyappa Temple Road, ,Venkatapura New Extension, ,
Koramangala, Bangalore-560034,Ph: 9243459895 / 65904481
Ph.no:Ph: 9243459895 / 65904481
Signature of candidate with date
CERTIFICATE
This is to certify that Mr/Ms PRASHANTH M bearing USN 1PI10ME079 is a student of the college and he/she may be
permitted to register for the examination. He/She shall satisfy the conditions of admission requirements and minimum
attendance as prescribed by the University before writing the examinations, failing which his/her application may rejected.
Date:
Signature of the HOD with seal Signature of the Principal with college seal
INSTRUCTIONS TO THE CANDIDATE
* Fee paid includes Application fee, Examination fee and Grade card fee.
* Please verify the details printed above and then affix your signature
* Kindly intimate the Office of Dean (Evaluation) immediately in case of any discrepancy noticed in the matter printed above.

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