LUKHDHIRJI ENGINEERING COLLEGE,

MORBI

APPLICATION FORM FOR NAMO e-TABLET DEPARTMENT:

FORM NO:
HSC SEAT NO:

1. STUDENT NAME:
2. CATEGORY
(GEN/SC/ST/PH):
3. HSC BOARD
4. HSC SEAT NO:
5. PASSING YEAR:
6. MERIT LIST NO:
7. MOBILE NO: STUDENT: GARDIAN:
8. EMAIL ADDRESS:

Required Documents:

1 COPY OF HSC MARKSHEET

2 COPY OF CASTE CERTIFICATE (SC/ST/OBC/PH)
3 COPY OF ADMISSION LETTER

SIGNATURE OF STUDENT

…………………………………………………………………………………………………………………………………………………………………

RECEIPT:

A sum of Rs. 1000/- received from Mr/Ms. .

HSC Seat No. , with application form for Namo e-Tablet.

Departmental Tablet Coordinator Name:

Departmental Tablet Coordinator Sign:

DEPARTMENT:
FORM NO.
HSC SEAT NO: