REGISTRATION NO:T&P/ /2010-11/__________

PUNJAB ENGINEERING COLLEGE,

CHANDIGARH.
PLACEMENT REGISTRATION FORM
(2007-2011)

Course: BE / ME Roll No.:_____________ BRANCH:______________

(Tick  appropriate)

1. Complete Name : ________________________

(Block Letters)
Paste your
2. Date of Birth : ________________________ Recent Passport Size
Photograph
3. Sex : Male / Female

4. Category : ________________________

5. Father’s Name : ___________________________________________

6. Mother’s Name : ___________________________________________

7. Correspondence Address : ___________________________________________

___________________________________________

_________________________Pin________________

Telephone No._______________________________

8. Permanent Address : ___________________________________________

___________________________________________

_________________________Pin________________

Telephone No________________________________

Alternate Contact No __________________________

9. E-mail ID : ___________________________________________
 ACADEMIC RECORD

Exam. Passed Univ./Board Year of Maximum Marks Percentage

Passing Marks/SGPA Obtained/SGPA
Class X
Class XII

BACHELOR OF ENGINEERING (BE):

1st Semester
2nd Semester
3rd Semester
4th Semester
5th Semester
6th Semester
7th Semester
8th Semester
MASTER OF ENGINEERING (ME):
1st Semester
2nd Semester
3rd Semester
4th Semester

CGPA OBTAINED UPTILL LAST B.E.

RESULT DECLARED M.E.

INSTRUCTION
 All the students are required to be present in formals whenever appearing for any Exam
or Presentation or Interview or Group discussion scheduled for placements.

I hereby declare that, to the best of my knowledge and belief, the particular
given above and the declaration made therein are true and I will abide by
the instructions provided above properly. In case of any discrepancy I take
the whole responsibility.

Dated:_________

Place _________
___________________
Signature of Candidate

__________________ _________________
Signature of Chief C.R. Signature of C.R.