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DELHI TECHNOLOGICAL UNIVERSITY Affix recent

(Formerly Delhi College of Engineering) passport size


REGISTRATION FORM FOR M.Tech/ MBA/ PhD PROGRAMME ……….201_ photograph
(cut whichever is not applicable) (DD/MM/YY)
M.Tech/ MBA/ Ph.D. (…………………)
(Specialization)
(..........)Year/ Semester
PART TIME / FULL TIME; SPONSORED/QIP
(cut whichever is not applicable)

1. Name (In Block Letter)…………………………………………........................................................ ………………….


2. DOB……………….…..3. University Roll No………………....……4. Reg.No. ........................................……
5. Gender…… .................., 6. Religion… ............................………....7. Category………….........................
8 .Father’s Name……………………………...……9. Mother's name…… ....………...... … .............……………
10. Address (Present)……………………………………………………….......................... …………………...
…………………………………………………….........................… Pin code ……………………
11. Address (Permanent)…………………………………………….......... …………………………………
………………………………………….................................. …….. Pin code…………………….
12. Mobile number…………………......... …… 13. Physical disabled (If yes, Percentage)………………..
14. Email Id………………………………………15. Nationality……............…16. Marital Status………
17. Experience Teaching/ Research /Industry (In years)……………………………………………….

I wish to register for following course during I/II/III semester (………………………………………..)

Department in which
running the course
Code Course Title Credit

............…………………………………
Date……………………… Signature of the Student

Registered in …………………………Programme at Department of……………….........................…………….

The courses mentioned are relevant with area of research of the student.

……………………………………. ……………………………………… ………………………..…………


Signature of Supervisor Signature of HoD Signature of DRC Chairman

Name: Name: Name:


Date……………………… Date………………………… Date……………………

DR Academics PG PG/ PhD (Coordinator)

Dean Academics PG

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