Centre for Converging Technologies, University of ...
Transcript of Centre for Converging Technologies, University of ...
Centre for Converging Technologies, University of Rajasthan Jaipur 302 004.
Student registration form for campus placement drive – 2014
Personal details:
1. Registration Number (CCT will allot) Photograph
2. First name
3. Middle name
4. Surname/Last Name
5. Gender
6. Mothers’ name
7. Personal mobile number
9. Email id
10. Date of Birth
11. Native place (name of place/district)
11. Local address
12. Permanent address (Parent residence)
13. Fathers’ mobile number, landline number
(residence)
Academic details (Schooling/ Junior college/Diploma) with examinations passed, % marks and year of passing
S.No. Name of the Course Name of the
Board/University
Year of Passing Marks obtained Percentage %
1. S.S.C.
2. H.S.C.
3. Diploma in -----
4. UG-B.Tech/BCA/MCA/B.Sc.
9
Declaration by the student:
Above information is provided by me and it is correct and complete. I will provide the corresponding proof as
and when required for the verification of the same.
Signature of the student
Verified and forwarded by
Principal/Director/Placement Officer
(Please Affix the seal)