University of Lucknow

COUNSELLING AND PLACEMENT CELL

Student Registration Form

MINI JOB FAIR 07 Dec.2017

Class/Course

Department..

University/Institution/College/Others

Personal Details:

1 Name of the student(In Block Letters)

2 Mobile No.
3 Email Id
4 Permanent Address
5 University/Institution/College/Others
6 Area of Interest
7 PAN No.-
8 Student Id. Aadhaar No.-

Name of the
Degree/Diploma/Certificate
S.No. course

th
1 High School or 10
th
2 Intermediate or 12

3 Graduation
..

4 Post Graduation
.
5 Diploma
6 Internship Details- Mention the name of the Company/Firm Along with duration
7 Work Experiences (if any)-
Declaration by the student: Above Information provided by me and it is correct and complete.

I understand that CPC LU is assisting me in arranging interactions/interviews with prospective employers.

However, the employment contract shall be solely and directly between the undersigned and prospective
employer. The CPC shall have no role in this matter.

I will provide the corresponding proof as and when required for the Verification of the same.

Signature of the Student

For Office Use Only

Receipt No.