Application No.*

Name of Candidate*

Father's Name *

Attach Address Proof Here*

Full Address*

Contact No.*

Email Id*

Name of Course Applied* Course Applied B.TECH(Lateral Entry) B.TECH ETO GME DNS Other

Batch No.*

Session Year.*

 

 

Bank Details (Candidate) : -

A/c Holder Name / Customer Name *

Bank A/C No.*

IFSC Code*

Bank Name (Branch)*

Fees Deposit Details: -

(Attach Copy of Bank Transaction if paid thru online /RTGS Mode / Demand Draft Receipt)

(A)Registration Fee Paid

Attach Copy of Bank Transaction

(B)Security Fee Paid

Attach Copy of Bank Transaction

(C)Other Fee Paid

Attach Copy of Bank Transaction

Grand Total

Attach Cancelled Cheque Copy or Front Page of Passbook of their personal saving bank account,

The refund Payment will Be Transfer Into Candidate Bank Account directly, (Refund payment will not be paid into Candidate's Parents or Relative bank account)

Attach Cancelled Cheque Copy *

Reason of Withdrawal From Course

Attach Copy of Reason

Please Note Carefully Following Instructions : -

1. Attach Xerox Copy of Address proof, Identity Proof and Aadhar Card of Candidate with this letter.
2. Those Candidates who paid the payment thru CASH mode, required to provide the original CASH deposit slip.
3. Candidate are required to attach cancelled cheque copy of their personal saving bank account. The refund payment will be transfer into candidate bank account directly. (Refund payment will not be paid into candidates parents or relative bank account)
4. Incomplete Application/ Information Will Be Not Accepted For Refund Process.

Refund Eligblity :-

1. If Medically Unfit, Please attach copy of Doctors medical Report.

2. If less than 60% in PCM Marks, please attach copy of Mark sheet.

3. Incase of any other reason, (Required Proper Details Along With Copy of Proof)