Form No.

S-10
w.e.f.: July 2015
ABES Engineering College, Ghaziabad

APPLICATION FOR RAILWAY CONCESSION FORM

The Registrar Date:
ABES Engineering College
Ghaziabad
Course
Adm. Gender
S. No. Name of Student (B.Tech./ Branch Year Age
No. (M/F)
MCA/MBA)
1
2
3
4

I/We am / are students of this college. I/We want to go home in_______________________ (winter / summer
/ Diwali / Holi) vacations as per the following schedule.
Date of Reservation from (Station
Description From To
Journey Name)
Onward Journey
Return Journey
I/we would like to request you to kindly issue me/us a Railway Concession document as per the above details.
I/We shall be highly obliged to you.

(Signature of Student with date)

Mob. No.:

(Signature of Office Staff with date)

Name:
Application received on:
[

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(For Accounts use only)

Received a sum of Rs._____ against issuance of Railway concession form for one side/both side journey.

(Signature of Accounts Section with date)

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(Signature of Student with date)

Concession form received on:

(Signature of office staff with date)

Name:
Concession form delivered on:

Note: Rs. 10/- for one side journey and Rs. 20/- for to & fro.