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Application Form Number:18156001157
Application For Supplementary Convocation Degree Certificate
Personal Data:
Surname: KHAN First Name: SUFYAN Middle Name: IQBAL Mother's Name: RASHEDA
Gender: Male
Address for Correspondence: 266 HOWSON ROAD, OPP BUSINESS BANK, DEVLALI CAMP, NASHIK, NASHIK, NASHIK, MAHARASHTRA
Pin Code: 422401
Phone: 02532492667 Mobile: 8983236283 Email ID: Sufi[email protected]
College/Institute Details:
Name of College /Institute : K.K. Wagh Institute of Engineering Education & Research (M.B.A.),
College Code: 1141
Examination: Bachelor of Engineering Faculty: Engineering
Month of Examination: April Year of Examination: 2017
Date of Result Declartion: 2017-07-12
Seat Number: B120130889 Permanent Registration Number (If Any): 71405135H
Special/ Principal/ Branch/ Method: Mechanical
Optional or Subsidiary a]: b]:
Subject for Restructured/Vocational:
Course: General
Whether Passed Partly by Papers & Partly by Research (For M.Sc/M.E. Students Only) : No
Whether Re-appeared & Passed Under Provision of Class Improvement Scheme : No
Application Fee Details: (Payment Mode : Online Payment)
Declaration:
I hereby declare that all statements made in this application are true, complete and correct to the best of my knowledge and belief.
I understand that in the event of any information being found false or incorrect, my candidature is liable to be cancelled or rejected.
Name in Devnagari Script (Marathi): Khan Sufyan Iqbal
Mother's Name(Marathi): Rasheda
Please sign inside
Place: Date:
box
Faculty Name:Engineering , Exam Code : Bachelor of Engineering (029 )
Note : Submit the Form with Stamped Challan / Online Payment Receipt & Final year Marksheet BY HAND to -
Student Facilitation Center, Savitribai Phule Pune University.
or By Post to -
Convocation Department, Examination Section, Savitribai Phule Pune University, Pune - 411007.
Online Payment Details
ApplicationID : 18156001157
Transaction ID : 0a39f39c7dd631e5739e
Amount : 990.00
Date & Time : Jan 2 2019 11:34PM
Result Description
CAPTURED
: