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    Students Identity-Card Form

    Uploaded by

    singhakanksha32645

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Students Identity-Card Form

    Uploaded by

    singhakanksha32645
    24 views2 pages

    Original Title

    Students Identity-Card Form.docx

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    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
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    Download as docx, pdf, or txt
    24 views2 pages

    Students Identity-Card Form

    Uploaded by

    singhakanksha32645

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    CSJM UNIVERSITY, KANPUR

    REGISTRATION FORM Fix your Latest


    Passport Size
    FOR Photograph

    Student Identity Card


    Personal Information :-
    (USE CAPITAL LETTERS ONLY)
    Surname : …………………….……………………………….. Forename : …………….……...
    …………………………….

    Email. : ……………………………………….. Department. : ……………………..…. Course. : ………………………….

    Father’s Name : …………..…………………….……………………… Mobile No. : …………………………………….


    …

    Local Guardian Name. : ………………….


    ……………………………………………………………………………………

    Mobile No. : ……………………………………..… Email. : ………...


    ………………………………………………………

    DOB. : ..…….…………………………………… Year of Session / Batch :


    ………………………………………………….
    Gender : M/F/T : …………….. Blood Group :………...…. Aadhaar No. (Enclosed Copy). : ……...
    …………………………
    Contact Information :-
    Permanent Address. :
    ……………………………………………………………………………………………….
    ………………………………………………………… City. : …………………………... Pin. :
    …………………

    Local Address. :
    …………………………………………………………………………………………………….

    ………………………………………………………… City. : …………………………... Pin. :


    …………………

    Student Contact No. : ………..……………..………… Emergency No. : ….………………………………….….

    Email ID. : ………………………………………………………………………………………………………….


    Declaration and Undersigned : - The undersigned would like to Applied for library membership. I am aware of
    undertake to abide by the copyright act 1986 and amendments. I will update to library of any change in my contact details.
    I agree to observe the library rules.

    Date :- (Student Signature)


    The Photograph and details furnished by student is verified and found correct as per official records of
    Department/Institute. He/She has deposited the course fees for the current session ……………………………….
    ………………………………….

    Seal of Dept/Institute (Signature of HOD)

    For Central Library Official use only :


    Library ID. : ….………………………………………….. Issued No. : ………….…..
    ……………………………
    Valid Upto. : ………………………………….…………………………………………………………………….

    (Staff Signature)

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