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GTU Civil Engineering: Home Date: 4 7 2016

The document is an online registration form for a Diploma to Degree Engineering course. It contains details of the candidate Amir Mahmad Abid Sabirmad including personal information, educational qualifications, contact details, and a declaration agreeing to abide by institutional rules. The form requests information such as name, date of birth, gender, category, family income, educational boards, marks obtained, address, mobile number, email and password to complete the registration.

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abdulyunus_amir
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92 views2 pages

GTU Civil Engineering: Home Date: 4 7 2016

The document is an online registration form for a Diploma to Degree Engineering course. It contains details of the candidate Amir Mahmad Abid Sabirmad including personal information, educational qualifications, contact details, and a declaration agreeing to abide by institutional rules. The form requests information such as name, date of birth, gender, category, family income, educational boards, marks obtained, address, mobile number, email and password to complete the registration.

Uploaded by

abdulyunus_amir
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
You are on page 1/ 2

7/4/2016

RegistrationForm
Date:472016

Home
::OnLineRegistrationForm::

::CANDIDATEDETAILS
Name: AMIRMAHMADABIDSABIRMAHMAD

Course: DiplomaToDegreeEngineering

UserId: DD17496

DateofBirth: 08Dec1996

Board: GTU

PassingCourse: CivilEngineering

::BASIC DETAILS
Gender :
Category :
SubCategory :
TuitionFeeWaiverScheme :

Male

Female

OpenGeneral
Other

Transgender
SC

ST

SEBC

In/ExServiceman

OpenEWS

PhysicalHandicapped

IamInterested

IamNotInterested

FamilyAnnualIncome :
Mother'sName :

NAFISHASABIRMAHMADAMIR

Father'sName :

SABIRMAHMADABDULMAJIDAMIR

Nationatily :

Indian

Other

::10 THE XAMDETAILS


ExaminationBoard :

Gujarat

SeatNo./RollNo. :

B549009

MonthandYearofPassing :

03

CBSE

Other

2012

PER%DATACOMPULSARYSUBJECTS
Obtained

294

500

Outof

Per

58.8

::12 THSCIENCEE XAMDETAILS


HaveYouPassed12thScienceExam :

Yes

No

::DIPLOMAPASSINGDETAILS
DiplomaPassingBoard :
DiplomaPassingBranch :
EnrollmentNo/ExamNo/SeatNo./RollNo. :
MonthandYearofPassing :
DiplomaPassedState :

GTU
CivilEngineering

126380306576
03

2016

Gujarat

ObtainedOutof
STPI(LastTwoSem) :
CGPA :

10.4000

20

6.8200

10

::OTHER DETAILS
UserID :

DD17496

Passwordlengthmustbeof612charector,itmustbecombinationofAlphanumericwithspecialcharectorandoneCapitalletter
ForExample:Test@123
ChoosePassword* :

ConfirmPassword* :

http://gujacpcadm.nic.in/Candidate/Registration.aspx

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7/4/2016

RegistrationForm
ContactAddress* :

ASHIYANA,
OPP.RLY.LOCOSHED,
POLICEH.Q.ROADABRAMA.

City :
District :
Taluka :
PinCode :

VALSAD

Valsad

VALSAD

396001

ContactNo. : STDCode
MobileNo.* :
EMailAddress :

PhoneNo

8460003127

[email protected]

DECLARATIONOFTHECANDIDATE
Idoherebydeclarethatalltheparticularsindicatedabovearetrueandcorrecttothebestofmyknowledgeandbelief.IhavereadtheAdmissionRulesandInformation
Brochure,andIshallabidebyalltherulesandothertermsandconditionsforadmission.Intheeventofsuppressionordistortionofanyinformationprovidedbyme,I
understandthatadmissiongrantedbytheAdmissionCommitteeshallbeliableforcancellation.IalsounderstandthatthedecisionoftheAdmissionCommitteeregarding
myadmissionshallbefinalandIshallbeliablebyitsdecision.Further,Ifaddmitted,Ipromisetoabidebytherulesandregulationsoftheinstituteasapplicableduring
thecourseofstudy.Iamalsoawarethatraggingisbannedandif,foundguilty,Ishallbeliableforpunishmentsundertherules.Iabidetopaythefeesasdetermined
bytheFeeRegulatoryCommittee/stateGovt.

Iaccept

SUBMITREGISTRATIONDETAILS

IDecline

http://gujacpcadm.nic.in/Candidate/Registration.aspx

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