INTEGRATED ACADEMY OF MANAGEMENT AND TECHNOLOGY,GhaziabadSTUDENT REGISTRATION FORM

(Provisional: Subject to clearance of dues and as per academic/administrative rules)Reference ID: 2972014233651Course and Session: PGDM/ 2013-2015 (PGDM only) Date: 29-7-2014 Time: 23:36:51

Roll No: PG-13-017 Roll No.(University): PG-13-017

Name: MANAS KUMAR DASH Semester/Trimester: IV

Fathers Name: DIPAK KUMAR DASH Mothers Name: UJJWALA DASH

Mobile No.(Father): 9800094579 Mobile No. (Candidate): 8506949362

Present Address: SINDURIA,SHIPUR,EGRA,PURBA MEDINIPUR

Permanent Address: INMANTEC BOY'S HOSTEL,GHAZIABAD,201009

Tehsil/District: PURBA MEDINIPUR Tehsil/District: GHAZIABAD

Pincode: 721448 Pincode: 201009

Date of Birth: 1-1-1991 Email: manas.ds2013@gmail.com

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I, solemnly affirm that:1. The above-mentioned details are correct. In future if there is any change in above details, I will update the concerned authorities myself without delay.2. I will achieve minimum 75% attendance throughout the Semester to appear in the examination.3. I will not use mobile phone inside class room/ seminar hall/ committee room , in case I am found using mobile it may be seized by the concerned authorities and disciplinary action can be initiated against me.4. I will carry & wear my Identity card inside the campus at all times; in case I fail I may not be allowed to enter the campus.5. Security of Laptops, mobile phone, books, ID-cards and other personal valuable items will solely lie on me. (both at campus and hostels)6. I am fully aware that I have to vacate the hostel by 31st May 2015 and in case I want to continue to avail the hostel facility for next session , I will submit a written request to the hostel warden by 2nd April 2015.7. I will wear Uniform on prescribed days and whenever asked for, in case I fail I may not be allowed to enter the campus or a fine may be imposed.8. I will read the notices/circulars placed on the notice board and uploaded on the CMS to get the updates related to Fee payment scheduled, rules and guidelines etc.9. I will be solely responsible for renewal of re-examination Marksheet from university.

Candidate Program Coordinator Registrar

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