Chaudhary Charan Singh University, Meerut

Registration Form for Regular and Self finance Colleges (Session-2011-12) Name of Course : M.COM. 1st Year
College Choice1 College Choice2 College Choice3 Name of Student Father`s Name Mother`s Name Date of Birth Caste Intermediate stream Original Resident of : D N COLLEGE, MEERUT : M M COLLEGE, MODINAGAR(GHAZIBAD) : MEERUT COLLEGE, MEERUT : VIPIN KUMAR : SHRI GANGA SHRAN SHARMA : SMT BALESH : 15-08-1991 : General : COMMERCE : U.P. Nationality : INDIAN Nationality : INDIAN Nationality : INDIAN Sex : Male Subcategory : None Medium of Examination : HINDI

Reg No:11212472

Permanent Address :
SHYAM SINGH VIHAR GALI NO-8 NEAR IRON BRIDGE MODINAGAR MODINAGAR GHAZIABAD Pin : 201201 Attested photograph by The Principal or any Gazetted Officer

Present Address :
SHYAM SINGH VIHAR GALI NO-8 NEAR IRON BRIDGE MODINAGAR MODINAGAR GHAZIABAD Pin : 201201 Phone No : 8430096212 Description of Examination:
Name of Examination High School Intermediate Graduation Post Graduation Other Subject COMMARCE COMMARCE B.COM Name of Board/University U.P.BOARD U.P.BOARD CCS UNIVERSITY Roll Number 392912 244690 1106230538 Years 2006 2008 2011

Signature of Candidate
Division IIND IIND IIND Mrk obt 293 293 639 Mrk max 600 500 1200

Details of previous examination passed from C.C.S. University(if any) : Sports Certificate : No Is Parents CCS Employee : No Declaration

Is CCS Student : No

I VIPIN KUMAR(11212472) 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

ALLAHABAD BANK
Registration fee for Regular and Self finance Colleges (Session-2011-12) : 50023710911 : Chaudhary Charan Singh University, Meerut : 11212472 : VIPIN KUMAR : 11212472 : 01 Amount 50/NIL Rupees Fifty Only

Student Copy

Account No Account Name Id/Ref No Name of Student Application No. Course/Class Fee Head

To be entered by Bank employee

Name of Course : M.COM.-1 Registration Fee (Non Refundable) Bank Charges Amount in words

Signature of Bank Official

BANK CHALLAN

ALLAHABAD BANK
Registration fee for Regular and Self finance Colleges (Session-2011-12) : 50023710911 : Chaudhary Charan Singh University, Meerut : 11212472 : VIPIN KUMAR : 11212472 : 01 Amount 50/NIL Rupees Fifty Only

College Copy

Account No Account Name Id/Ref No Name of Student Application No. Course/Class Fee Head

To be entered by Bank employee

Name of Course : M.COM.-1 Registration Fee (Non Refundable) Bank Charges Amount in words

Signature of Bank Official

BANK CHALLAN

ALLAHABAD BANK
Registration fee for Regular and Self finance Colleges (Session-2011-12) : 50023710911 : Chaudhary Charan Singh University, Meerut : 11212472 : VIPIN KUMAR : 11212472 : 01 Amount 50/NIL Rupees Fifty Only To be entered by Bank employee

Bank Copy

Account No Account Name Id/Ref No Name of Student Application No. Course/Class Fee Head

Name of Course : M.COM.-1 Registration Fee (Non Refundable) Bank Charges Amount in words

Signature of Bank Official

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