VELAGAPUDI RAMAKRISHNA SIDDHARTHA ENGINEERING COLLEGE

(AUTONOMOUS)
VIJAYAWADA - 520 007
APPLICATION OF REGISTRATION FOR ADMISSION INTO NEXT HIGHER CLASS
ACADEMIC YEAR 2019-20

Recent Passport size

Recent Passport size
photograph of the
photograph of the Father
Candidate

NAME OF THE CANDIDATE ROLL NO:

CLASS FOR WHICH REGISTRATION IS SOUGHT COURSE DEPT: YEAR: SEM:

(B.TECH / MCA / MBA / M.TECH)

SCHOLARSHIP / NON SCHOLARSHIP TUITION FEE PAID YES / NO DATE OF PAYMENT:

NAME OF THE FATHER ANNUAL INCOME:

PHONE NO: Res:

Cell
Land

CATEGORY: SC / ST / BC - A, B, C, D, E / PH / EBC

DID YOU RECEIVE SCHOLARSHIP FOR THE LAST YEAR YES / NO

ADDRESS FOR CORRESPONDENCE PERMANENT ADDRESS

NO. OF CREDITS REQUIRED FOR PROMOTION TO NEXT HIGHER CLASS

NO. OF CREDITS ALREADY SECURED BY THE CANDIDATE

PROMOTION TYPE (REGULAR / CONDITIONAL)

UNDERTAKING
I Mr. / Ms _________________________________________________________________________ (Name) Son / Daughter of
Sri ______________________________________________________ (Father's Name) hereby affirm that, I shall scrupulously adhere to the

rules of conduct being in force at the Institution. I will not take up or participate in any activity that may amount to tarnishing the image

of the instituion. I am aware of the academic regulations of my course and specially with regard to attendance, internal and external
marks / credits requirements for promotion to next higher semester.

Date: SIGNATURE OF THE CANDIDATE

I will pay all the fee stipulated by the College Authorities from time to time. I will hold responsibility for the character /

behavior of my Son/Daughter during his / her stay in the collge. I am aware of the academic regulations and see that my son / daughter

follow the academic regulations of his / her course and specially with regard to attendance, internal and external marks / credits

requirements for promotion to next higher semester.

Date: SIGNATURE OF THE PARENT

Registration for next Higher Semester

verified

Scholarships Accounts Dept. Clerk HOD