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Exam Appu

This document is an examination application form for Arunkumar R, a student in the B.E. Civil Engineering program at St. Peter's Institute of Higher Education and Research. It provides his personal details like name, date of birth, address, as well as academic details including the number of arrear papers from various semesters and the total examination fees to be paid. The form is to be submitted to the Controller of Examinations through the Head of Department.

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Pooja Rajendran
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140 views4 pages

Exam Appu

This document is an examination application form for Arunkumar R, a student in the B.E. Civil Engineering program at St. Peter's Institute of Higher Education and Research. It provides his personal details like name, date of birth, address, as well as academic details including the number of arrear papers from various semesters and the total examination fees to be paid. The form is to be submitted to the Controller of Examinations through the Head of Department.

Uploaded by

Pooja Rajendran
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Last Date: 21.03.

2020 Registration No : SP 16 CEU 330

St. PETER’S INSTITUTE OF HIGHER EDUCATION AND RESEARCH


(Deemed to be University U/S 3 of the UGC Act, 1956)
Avadi, Chennai – 600 054.

END ASSESSMENT, APRIL /MAY – 2020


B.E. / B.Tech.
(On -Campus Programme)
(2016-17 Batch)

EXAMINATION APPLICATION FORM


Branch: B.E. CIVIL ENGINEERING

1. Name in BLOCK LETTERS : ARUNKUMAR R


(as in the 10th certificate in English)

2. Gender : Male

3. Date of Birth : 12-11-1995

4. Nationality : INDIAN

5. Social Status and Community : SC- HINDU

6. Father’s Name : B RAJENDRAN

7. Mother’s Name : R VASANTHI

8. Blood Group : A1+

9. Aadhaar Number : 304562853811

10. (a) Present Address with pin code : NO 57 RUKUMANI NAGAR ADYAR ,
CHENNAI
(in BLOCK LETTERS) PINCODE : 600020

(b) Permanent Address with pin code : NO 57 RUKUMANI NAGAR ADYAR,


CHENNAI
(in BLOCK LETTERS ) PINCODE: 600020

(c) Mobile Number : 8072146667

P.T.O
11. Particulars of Educational qualification:

Qualifications Board/College/ Month and year Reg. No. Average marks /Class
University of passing

Note: Copies of the certificates and Transfer Certificate are to be enclosed.

No. of Papers
Semester Theory Practical
12. (a) No. of papers in the End Assessment :
Arrear papers in VIII Semester
Arrear papers in VII Semester
Arrear papers in VI Semester 5
Arrear papers in V Semester
Arrear papers in IV Semester 5
Arrear papers in III Semester 1
Arrear papers in II Semester 3
Arrear papers in I Semester

Amount
(b) Total amount of End Assessment Fee : (Rs.)
VIII Semester (Arrear)*
VII Semester (Arrear)*
VI Semester (Arrear)* 2500
V Semester (Arrear)*
IV Semester (Arrear)* 2500
III Semester (Arrear)* 500
II Semester (Arrear)* 1500
I Semester (Arrear)*
Total 7000

(c) Date of Payment of Arrear Examination Fee: NOT PAID

(Enclose a copy of the challan)


13. Whether Transfer Certificate is received. : Yes / No
(If yes, enclose a copy)

I certify that all the above particulars given by me are correct.


Date: Signature of the Student

* Arrear Examination Fee Structure Theory : Rs.


500 per paper Practical :
* Rs. 250 per practical

SIGNATURE OF HOD (With Seal)


Note: The filled-in application is to be submitted to the Controller of Examination through the HOD concerned.

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