16/11/2017 convocurrent.gtu.ac.in/convocation.aspx?

x497Z8nR8yM0gbmi02vpV9kq/fwWiSqx

Convocation Year :2017

Gujarat Technological University
Application form for

GTU Degree / Diploma Certificate

131130119546
Institute [113] SAL COLLEGE OF ENGINEERING

1. Name of Applicant : SATYAM A TRIVEDI

2. Correspondence :

Address : 1-B DIVYA 1, 14 SUMANGALAM SOCIETY, OPP. DRIVE-IN-CINEMA, B/H SWAMINI

COMPLEX, BODAKDEV Ahmedabad Gujarat 380054

Email : satyamtrivedi619@gmail.com

Contact. (Phone) : (Mob.) : 8511959959

Aadhar : 652535095270

4. Passing Out Educational Qualification :

BE
Branch : [19] MECHANICAL ENGINEERING

Month & Year passing : Jun 2017

CPI : 7.68

CGPA : 7.95

5. Whether willing to receive degree in person or in absentia (Tick) : Absentia

6. Coming with parents : No
7. Transaction Details :
Degree/Diploma Payment Detail
Challan No. : DUDU81068381
Total Amount. : 500
Branch Name. : SBI
Challan Date. : 16-Nov-2017
8. Part of GTU Allumni :

Allumni. : NO

: Declaration :
I agree that I have submitted my own detail, the detail are right as per my confirmation. If this information will be wrong then I may be bound with
legal affairs or advocate illegal activity. I am also confirmed that I register here for my own convocation application, if i found with registering other's
information, then GTU can claim illegal activity to me. I must use every effort to keep my password safe and should not disclose it to any other
person. I shall also not permit, either directly or indirectly, any other person to utilize my User ID or password. GTU not responsible, if any other
person misuses the service by logging into your account.

Very Important:
* I have verified all my details (Including Name , Photo & Other Degree Certificate Details) and I
know that it cannot be changed later on after printing Degree Certificate.
Date : 16/11/2017
Place : Signature of Applicant

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