fresh programmes amity university
TRANSCRIPT
Program Name
Program Code
Name of School/ University
Year of Passing
Board/ College/ University
Main Subject Aggregate of Marks
Space for passport
size photograph
(To be accompanied
by a govt. issued
photo ID)
E-mail Address Contact Number __________________________ Correspondence Address ___________________________________________ ___________________________________________
___________________________________________
Student Enrolment Form
Academic session………………………..
Application Status
Full Name of Student
(in Block Letters)
Mr. Last Name Middle Name First Name
Ms.
Nationality _______________________ State of Domicile ______________________
Date of Birth Date Month Year
Sex Male Female
Father’s / Husband Name
Educational
Qualifications
(including 12 yrs
of formal
schooling)
Amity Center for e-Learning (ACeL), F-2 Block, Second Floor, Sector 125 Campus, NOIDA 201303 (UP), INDIA
Last Name Middle Name First Name
Name and Address of Organization Designation From To
Undertaking:
I Solemnly affirm that the above information made and furnished by me is true and correct. Further, I
am being admitted to the above stated programme entirely on my request and I agree to abide by all the
rules and regulations of Amity University. In the event of suppression or distortion of any fact like
educational qualifications, nationality, etc…, made in the Enrollment Form, I understand that my admission is liable for cancellation.
Date: _______________________
Place:_______________________
(Signature of Student)
Particulars Verified
Signature:_________________________
(Head of the Study Center)
Office Seal Name/ Designation______________
For Use by office
Student Enrolled/Not Enrolled
Enrollment No. Attended
Amity Center for e-Learning (ACeL), F-2 Block, Second Floor, Sector 125 Campus, NOIDA 201303 (UP), INDIA
E-mail: [email protected]
Educational
Qualifications
(including 12 yrs
of formal
schooling)