DSY Enrollment Form-2021-22 - 2

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RASHTRASANT TUKADOJI MAHARAJ NAGPUR UNIVERSITY Format - C

ENROLLMENT FORM 2021-2022

Enrollment No. RTMNU/ Branch: Year: Direct Second Year


To,
The Registrar
Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur

Sir,
I desire to enroll in Rashtrasant Tukadoji Maharaj Nagpur University as a regular student.
Photo of Student

College Name: St. Vincent Pallotti College of Engg. & Tech. Nagpur Aadhar Number: ______________________________

D.T.E. APPLICATION ID (indicated on Final CAP Allotment Letter Received from College):
First Name : Middle Name: Last Name:

Mother's Name: Father's Full Name:

Student’s full name as per mark sheet:

Postal Address: Taluka: City: State: Pin:

Permanent Address: Taluka: City: State: Pin:

Mobile No.: Mail Id

Date of Birth : Aadhaar No.:


Category: Caste :Sub-caste: Religion: Gender:
Nationality: Whether Handicapped/Blind: Income:
Name of branch in which admitted : Semester: III Medium: Eng.
Subject To be Offered in III Semester B.E. :

Examination Passed By Me (Diploma): Mark sheet No.: Roll No. Year of passing Passing session

Board / University :

Obtained marks Total Marks Division % secured CGPA

Date of Admission in College: Date of Payment : RECEIPT NO.:


The above information furnished by me is true and correct:
Date : Blood Group : Signature of Student

Parent / Guardian is EBC = Y/ N Parent / Guardian Annual Income: Occupation :

Documents to be attached:
(A) Students Passed Diploma from MSBTE: (B) Students Passed Diploma from Other than MSBTE:
1. Diploma all Semester mark sheets
2. Caste Certificate/ Validity Certificate (if Any) 1. Caste Certificate/ Validity Certificate( if Any) & Diploma all Semester mark sheets
3. Leaving Certificate / TC 2. Leaving Certificate / TC
4. Copy of Final CAP Allotment Letter (Received from College) 3. Copy of Final CAP Allotment Letter ( Received from College)
5. Fees Paid Receipt Copy
6. Eligibility Certificate 7. Copy of Aadhar card 4. Fees Paid Receipt Copy
5. Migration Certificate
6. Eligibility Certificate 7. Copy of Aadhar Card

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