Chaudhary Charan Singh University, MeerutRegistration Form for Regular and Self finance Colleges (Session-2011-12)

Name of Course : M.SC. (CHEMISTRY) 1st Year Reg No:11169571

College Choice1 : M M COLLEGE, MODINAGAR(GHAZIBAD)

College Choice2 : L R COLLEGE, SAHIBABAD

College Choice3 : R.C.C.V. GIRLS DEGREE COLLEGE,GHAZIABAD

Name of Student : ISHA Nationality : INDIAN

Father`s Name : SH. O.P. ARORA Nationality : INDIAN

Mother`s Name : SMT. CHANDER ARORA Nationality : INDIAN

Date of Birth : 12-02-1991 Sex : Female

Caste : General Subcategory : None

Intermediate stream : SCIENCE WITH MATHS Medium of Examination : ENGLISH

Original Resident of : Other State

Attested photograph by

The Principal or any

Gazetted Officer

Signature of Candidate

Subject Name : (CHEMISTRY)

Permanent Address :C-192,D.D.A. L.I.G. FLATS EAST OF LONI ROAD, DELHI-93

DELHI

NORTH-EAST

Pin : 110093

Present Address :C-192,D.D.A L.I.G FLATS EAST OF LONI ROAD, DELHI-93

DELHI

NORTH-EAST

Pin : 110093

Phone No : 9999686928

Description of Examination:

Name of Examination Subject Name of Board/University Roll Number Years Division Mrk obt Mrk max

High School ENG,SANS,MATHS,SCI,

SST,HINDI

CBSE 6317757 2006 1 360 600

Intermediate ENG,MATHS,PHY,CHEM

,BIO,PHY.EDU

CBSE 6215750 2008 2 339 600

Graduation CHEM,ZOO,BOT,ENG,M

ATHS

DU 3052703 2011 2 1 1

Post Graduation

Other

Details of previous examination passed from C.C.S. University(if any) : N/A

Sports Certificate : No Is Parents CCS Employee : No Is CCS Student : No

Declaration

I ISHA(11169571) hereby declare that the information given in the application form is true to the best of my knowledge and belief. In case any

information is found untrue, my registration may be cancelled, for which no claim of refund of fee would be raised by me.

Bank Challan Detail (To be filled by Student)

Journal Number : Date :

(Signature of the Applicant)

NOTES:

1. Prescribed Registration Form may be submitted to any of three Regular/Self Finance colleges affiliated to the University selected by the candidate

before 12th July 2011.

2. Registration does not entitled the candidate for Admission.

3. Admission on Merit basis as per University guidelines.

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BANK CHALLAN Student CopySTATE BANK OF INDIA

Registration fee for Regular and Self finance Colleges (Session-2011-12)

Account No : 30990406022 To be entered by Bank employee

Account Name : Chaudhary Charan Singh University, Meerut

Id/Ref No : 11169571

Name of Student : ISHA

Application No. : 11169571

Course/Class : 01

Name of Course : M.SC.-1

Fee Head Amount

Registration Fee (Non Refundable) 50/-

Bank Charges NIL

Amount in words Rupees Fifty Only Signature of Bank Official

BANK CHALLAN College CopySTATE BANK OF INDIA

Registration fee for Regular and Self finance Colleges (Session-2011-12)

Account No : 30990406022 To be entered by Bank employee

Account Name : Chaudhary Charan Singh University, Meerut

Id/Ref No : 11169571

Name of Student : ISHA

Application No. : 11169571

Course/Class : 01

Name of Course : M.SC.-1

Fee Head Amount

Registration Fee (Non Refundable) 50/-

Bank Charges NIL

Amount in words Rupees Fifty Only Signature of Bank Official

BANK CHALLAN Bank CopySTATE BANK OF INDIA

Registration fee for Regular and Self finance Colleges (Session-2011-12)

Account No : 30990406022 To be entered by Bank employee

Account Name : Chaudhary Charan Singh University, Meerut

Id/Ref No : 11169571

Name of Student : ISHA

Application No. : 11169571

Course/Class : 01

Name of Course : M.SC.-1

Fee Head Amount

Registration Fee (Non Refundable) 50/-

Bank Charges NIL

Amount in words Rupees Fifty Only Signature of Bank Official

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