Rajiv Gandhi Proudyogiki Vishwavidyalaya, Bhopal

Examination Registration Form Cum Receipt

Session:

Semester/Year:

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Student Details

Enrollment No.:

Branch/Course:

Scheme:

Student's Name (In Capital Letters):

Gender:

Father's Name (In Capital Letters):

Category:

Mobile No.:

Email ID:

Status (Regular/Ex/Supply):

Subject Details for Examination

S.No.	Subject Code	Subject Name	Exam Type	Status

Declaration by Student

I hereby declare that the information furnished above is true to the best of my knowledge and belief. I have read all the rules and regulations of the University regarding examinations and agree to abide by them. I also understand that my candidature may be cancelled if any information is found to be incorrect.

Date:

Place:

Signature of Student:

For HOD

Certified that the student has fulfilled the attendance requirements and is eligible to appear for the examination. The details provided have been verified.

Signature Department HOD (with Seal):

Date:

For Office Use / Verifying Officer

Certified that the student has fulfilled the attendance requirements and is eligible to appear for the examination. The details provided have been verified.

Signature of Verifying Officer (with Seal):

Date: