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    ACE Scanner - 2024 - 06 - 06 2

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    ACE Scanner - 2024 - 06 - 06 2

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    ACE Scanner_2024_06_06 2

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    8 views1 page

    ACE Scanner - 2024 - 06 - 06 2

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    Form design

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    © All Rights Reserved
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    NATIONAL INSTITUTE OF TECHNOLOGY

    HAMIRPUR (H.P.)
    (July-2024)
    Supplementary Examination Form
    Roll No.: Paste latest
    Self-attested
    Name (In English) .. photograph
    (as per Matriculation Certificate) Date of Birth:
    Father's Name. Permanent Home Address (in CAPITA
    CAPITAL LETTERS)
    Address for correspondence (in

    ...

    Tel. No./ Mobile No.:


    Pin Code:
    E-mail address:
    Tel. No./ Mobile No: Em
    i al deress:

    Results of Various Semesters


    rse code(s)
    Semester SGPI CGPI Repeat (if any), Give relevant cou
    4 5 6
    2 3
    1

    20d
    3rd
    4th
    5th
    6th
    7th
    8th
    gt h
    10th

    The students should fill this information carefully/leg ibly and correctly.
    Note: - (1)
    nI case any discrepancy is found later on, the candidate wil solely be responsible for the same.
    (ii) enclosed with this form by the
    (iii) Copy of Supplementary Examination fee Receipt of Rs.500/-/Proof be
    student. Amount Rs500/- Date.......
    Examination Fee Receipt No.:- .
    (Signature of the Student)
    Dated

    (Part -11) Name of Teacher who taught


    Semester Rol. No. Course Code *Title of the course of
    Class: B.Tech/B. Arch. M.Tech./ Branch as per
    (Strictly Supplementary examination this course
    M.Arch./ Dual Degree/MBA/MSC relevant old/new
    scheme)
    (Strictly sa per relevant old/new scheme)

    ired ot fill separate


    #The student appearing in more than one courses during supplementary examination is requ
    examination form for each course. *[Convener (DBPC/DMPC)]
    Deptt_
    ent should verify the course code and titles of the course
    Note: *The Convener (DBPC/DMPC) of the Departm
    ut of the result, to be produced y
    b the stud ents at the time
    of Supplementary Examination, from printo
    of form submission in the concerned Department.

    The Head of Department


    Name of Department

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