Shri Shivaji Science College, Amravati

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2019-2020

Email *

Career Counseling Cell - Registration Form

Dear Students, All the fields in the registration form are compulsory. After submission of this form, you need to deposit registration fees of Rs. 100/- with Prof. Kirtidwaj Gawai, Deptt. of Environmental Science to confirm your enrollment. Please check your message appearing after successful submission. The copy of the form will be mailed to you as a receipt of registration form.

Your College ID (Roll No) *

Surname *

First name *

Father's name *

GENDER *

Male

Female

DATE OF BIRTH

YYYY

Category *

General

OBC

SBC

Class *

B. Sc.

B.C.A

M.Sc.

B.Voc.

Other:

YEAR *

First year

Second year

Third year

Subject Group (like Bio, PCM, CSM, BTB, etc.) *

Mobile No. *

BLOOD GROUP *

RH FACTOR *

POSITIVE

NEGATIVE

PREVIOUS EXAMINATION *

XII

B. Sc. I

B. Sc. II

B. Sc. III

M.Sc I

M. Sc. II

BCA I

BCA II

BCA III

Other:

PERCENTAGE / GRADE OBTAINED IN PREVIOUS EXAM

Declaration

I hereby declare that all the statements made by me in the registration form are true and complete to the best of my knowledge and belief and nothing has been concealed or suppressed. I also understand that in enrollment for this cell compel me to regular participation in activities. I will always convey my career achievements to the college.

A copy of your responses will be emailed to the address you provided.

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