Application Form

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Veer Madho Singh Bhandari Uttarakhand Technical University, Dehradun

A State Government University Established By Uttarakhand State Government


Vide Act No.415 of 2005
ACADEMIC REGISTRATION & ENROLMENT FORM : 2022-23

Personal Details
Registration No. : ST0000018007
Application No. : AP220000013609
College Code : 012
College Name : TULAS INSTITUTE DEHRADUN
Course Name : B.TECH
Branch Name : Electrical & Electronics Engineering
Semester / Year : 5 Semester
Student's Name : RAZOTO VESWUH
Father's Name : VETATSO VESWUH
Mother's Name : VEYISALU VESWUH
Date of Birth : 30/08/2000
Gender : Male
Identification Marks : A mole on the left side of the nose
Fee Category : False
Aadhar Card No. : N/A Category : ST
Religion : Christian Sub Category : None
Admission Mode : N/A Nationality : Indian
Year of Admission : 2021 Country : N/A
Admission Quota : N/A State : Nagaland
Driving Licence No. : N/A District : Phek
PAN No. : N/A Pin Code : 797108
Student's Email ID : razotoveswuh.202002008@tulas.edu.in Father's Mobile : 8415840112
Student's Mobile No. : 9366067913 Digilocker ID : N/A
Student's other Mobile No.: 8794555495 Academic : N/A
Blood Group : O+ Bank Credit ID
Address : Yoruba village, Phek, Nagaland

Qualification Details

Name of Exam Board/University Year Roll No Max Mark Obt. Mark Percentage
10th Nagaland Board of School 2016 1651119 600 389 64.83
Education
12th State Council For Technical 2021 18010202 5325 3879 72.85
Education
Fees Details

Registration Fees (Rs) Enrolment Fees (Rs) Total Fees (Rs)


0.00 0.00 0.00
NOTE:-Attested Photocopy of Marks sheet of Qualifying Examination (i.e. Intermediate,Graduation Post Graduation etc.) and other
relevant documents, must be attached with enrolment form.

DECLARATION BY CANDIDATE
1. I have read the rules in the relevant Ordinances applicable to me and undertake to abide by them and will not claim any benefit out
of some error or mistake on the part of the University, which is not allowed under the ordinances.
2. I hereby declare that the entries in the form are true to the best of my knowledge and belief, in case any entry in this form is found
to be false. I will have no objection if theUniversity disqualifies me from appearing in examination/cancels my registration or
debars me from appearing in the Examination in future.

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Veer Madho Singh Bhandari Uttarakhand Technical University, Dehradun
A State Government University Established By Uttarakhand State Government
Vide Act No.415 of 2005
ACADEMIC REGISTRATION & ENROLMENT FORM : 2022-23
3. I, hereby declare that I shall not indulge in any act of indiscipline in Institution and University
4. I hereby declare that I shall not be involving myself in any act that affects the dignity of any one.
5. I'm fully aware that the desired details of Digilocker/ABC ID/Aadhaar, if not submitted here, will have to be submitted by January
31, 2023. The registration/enrolment will remain provisional till submission of complete details & University will take necessary action
as deemed suitable and withald the examination result due to any discrepancy.

NOTE:-Those candidates who have been punished earlier for any reason are required to enclose the punishment order

Date: 12/12/2022
Signature of Candidate
CERTIFICATE BY THE HEAD OF THE INSTITUTION

· The entries made by the candidate in this Enrolment form have been checked and verified by the institute and are
certified to be correct and candidate is found eligible to be permitted for Enrolment in the University.The candidate has
deposited the requisite Examination and Enrolment Fee as prescribed by University.
· It is also certified that the said student has been admitted to the concerned programme within the he approved admission
capacity, prescribed by the University.
· It is undertaken that in case of this admission being beyond the prescribed intake capacity of programme and is found to
be violating the admission norms of the University, The University may cancel the admission
for which no claim shall be made by the Institution and student.

Date :_______________ Signature: _________________________

Place:___________________ Name of Head of Institution: _________________

Office Seal: _________________


NOTE:-
(1) Principal/Director should sign. himself on the above certificate and in no case facsimile stamp should be used.
(2) The attached photocopy of all the certificates & marksheet must be attested by Director/Principal Dean of Institute with
official Seal.

ENDORSEMENT BY UNIVERSITY
The candidate is enrolled in the university, however the university reserves right to cancel the enrolment in case of any
information found incorrect/misconduct or any unforeseen situation, in which university decides to do so.

Registrar
VMSBUTU, Dehradun

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