EXAMINATION REGISTRATION FORM

Name *

First

Last

Student ID *

Phone No. *

Course Name *

Semester *

Mode of Study *

A. SEMESTER 1 (S1) MODULES & RESULTS OBTAINED *

Full names of modules as they appear on the brochure, Results obtained and Grade.

B. CURRENT SEMESTER MODULES & CA RESULTS OBTAINED *

Full names of modules as they appear on the brochure, Results obtained and Grade.

Date of Payment *

Date of Registration *

ELSIMATE OFFICIAL: (THIS SECTION IS FOR OFFICIAL USE ONLY)

FINANCIAL VERIFICATION DONE BY:

EXAM FEE PAID?

TUITION FEE UP TO DATE?

SIGNATURE & DATE

ELSIMATE OFFICIAL: (THIS SECTION IS FOR OFFICIAL USE ONLY)

ACADEMIC VERIFICATION DONE BY:

CA MARKS VERIFIED?

IS THE STUDENT ACTIVE IN THE INSTITUTE IN THIS ACADEMIC YEAR?

STUDENT FILE NUMBER:

SIGNATURE & DATE