REQUISITION 'FOR PROJECT WORK IN APSRT'RC (Notification No'-PD-D5/2017, Dt.14.06.2,017) PHOTO

LName of the Student I.

2.Father's Name

3.QuaJJJicaticm details: a) Name of 'the College studying &

Address

b) Name of the Course studying (eg:Bg,/B.Te,ch/MEA etc.j)

c) Regd .. No./RoU No. in College d] Year of stud~ e) Institute I.D. subrnitted'(Yes/No)

4.Mobile No. 5 .. Project work details: a) Topic

b) Preferred place to do Project work c] Duration ()f Project work

, 6.Fee particulars: a) Amount b) MJZ.No. & Date

I

7. Is your Father/Mother working in APSRTC (Yes/No): a) If yes". indicate Name

b) Staff No. cl Design. d) Unit e) Letter submitted from Unit

OfficerfY e s./No r I 8. Requisition letter from the College

Principal/HOD/Guide endosed(Yes/No)

9. Email address of the student '.

lO.Aadhar No.of the student

Date: SIGNATURE OF THE STUDENT