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Pioneer Institute of Professional Studies, Indore

This document is an examination form for Pioneer Institute of Professional Studies in Indore. It requests information to register a student for an upcoming examination, including personal details, academic details, and payment details. The form collects the student's name, father's name, gender, class, specialization, enrollment number, and category. It also requests the student's previous academic results, subjects to appear for in the upcoming exam, and details of any previous attempts or subjects to carry marks forward from. The student must provide their photo, signature, and declaration of the truth of the information provided before submitting the form and paying the registration fee.

Uploaded by

Shubham Bhatewara
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32 views2 pages

Pioneer Institute of Professional Studies, Indore

This document is an examination form for Pioneer Institute of Professional Studies in Indore. It requests information to register a student for an upcoming examination, including personal details, academic details, and payment details. The form collects the student's name, father's name, gender, class, specialization, enrollment number, and category. It also requests the student's previous academic results, subjects to appear for in the upcoming exam, and details of any previous attempts or subjects to carry marks forward from. The student must provide their photo, signature, and declaration of the truth of the information provided before submitting the form and paying the registration fee.

Uploaded by

Shubham Bhatewara
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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PIONEER INSTITUTE OF PROFESSIONAL STUDIES, INDORE

(AN AUTONOMOUS INSTITUTE ESTABLISHED IN 1996 & IS AFFILIATED TO DAVV, INDORE)

Form No. :........................

EXAMINATION FORM

FORM COST RS.100/-

Note : All details should be written in clear handwriting in CAPITAL letters English only. Read all footnotes before filling.
Details written here will be printed on Marksheet. Incomplete Examination Form will be rejected.

Year of Examination

Roll No. (To be allotted by Exam. Section)

Class : MBA (FT) /MBA (PT) /BBA /BCA /B.Com ....................................................................... Semester .......................

Specialization : 1) ......................................................................... 2) .........................................................................

Enrollment No.
Gender

Attempt
No.

Reg./Ex./ATKT

Category
Gen/SC/ST/OBC

Affix your latest


passport size colour
photo
(within the box)

R/E/A

M/F

Verified by Principal
Seal & Sign.

Student's Name and Surname


Shri/Smt./Kum

.............................................................................................................................

Fathers/ Husbands Name : Shri .......................................................................................................................................

Mothers Name : Smt. ......................................................................................................................................................

Students
Address :

Telephone No. : .......................................... Mobile No. : ...............................................................................

Details of Previous Exams (Attested copies of Marksheets to be enclosed)


Name of Exam

Pass/ATKT

Subjects/Papers to appear in the Examination

Roll No.

Code No

Year

Marks obtained/
Total marks

Name of the
University/Board
passed from

Subjects/Papers to appear in the Examination

1.

7.

2.

8.

3.

9.

4.

10.

5.

11.

6.

12.

Code No

P.T.O.

-2-

For ATKT students


Marks to be carried forward of subjects already cleared :
Table below should be filled in by those candidates only who are repeaters in one or more subjects
Subject Description

S.

Code

Theory

Practical

Internal

Total

Out of

No.
Marks
Obtd

Out
of

Marks
Obtd

Out
of

Marks
Obtd

Out
of

1
2
3
4
5
6
7
8
9

ONLY FOR FINAL SEMESTER STUDENTS


(Please attach photocopies of all previous Semester Examination Marksheets cleared)

Ist Year

Year / Semester

Roll No.

Marks Obtained

Out of

Marks-Year of Passing

I Semester
II Semester

IInd Year

Total
III Semester
IV Semester

IIIrd Year

Total
V Semester
VI Semester

Fee Details :

Total

Receipt No. ........................................ Date ................................... Amount in Rs. ...........................

DECLARATION
I request permission to present myself at the ____________________ Examination to be held in __________________ conducted by
the Institute. I declare that the facts & information provided in the examination form above are complete & correct to the best of my
knowledge & belief. I am also aware that my admission shall become invalid if I make wrong declaration and undertake to abide by the
decision of the Institute in such a situation, even in cases when such wrong declaration is discovered subsequently.

Date : .................................

Full Signature of Student

(For Office Use only)


Signature of Receiving Clerk : ..........................................

Date : ..................................

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