Savitribai Phule Pune University

Maharashtra Institute of Technology, Pune

( PETROLEUM, POLYMER, PETROCHEMICAL )

(125 of 2011, SPPU)

Examination Form April/May 2017

Application Id: 2606

PRN : 71526417G
Course Name : T. E.(2012PAT.)(PETROCHEMICAL)
PUNCODE : CEGP010450 | COLLEGE CODE : 002
College : Maharashtra Institute of Technology, Pune

Instructions to the Candidate:

1.This Exam form along with fee amount should be submitted to the students section .
2.The students should attach attested true copy of the latest mark sheet alongwith this form.
3.This form will be considered ONLY AFTER APPROVAL from the Principal.

To,
The Controller of Examinations, (125 of 2011, SPPU) Maharashtra Institute of Technology,
Pune-411 038.
Madam/Sir, I request permission to present myself at the examination courses, mentioned below

1.Personal Details:
Name of the Applicant ARBAD SUDAM DATTATRAYA
Name of the Applicant's Mother ASHAMATI
Gender : MALE
Category OPEN
Medium of Instruction English

2. Applied Subjects Information :

Sem Subject Code Subject Name IN TH TW PR OR
6 312407 TRANSPORT PHENOMENA Y Y Y - -
6 312408 MASS TRANSFER-II Y Y - - Y
6 312409 REACTION ENGINEERING-I Y Y Y - -
6 312410 REFINING OPERATIONS Y Y - Y -
6 312411 PROCESS EQUIPMENT DESIGN Y Y - - Y
6 312412 SEMINAR - - Y - -

3. Fee Details
Fee type Form Fee
Form Fee 30
Exam Fee 640
Passing Certificate Fee (BE) 0
CAP Fee 135
Statement Of Mark Fee 135
Project Fee (BE) 0
Late Fee 0
Fine Fee 0
Total Fee 940
 Savitribai Phule Pune University

Maharashtra Institute of Technology, Pune

( PETROLEUM, POLYMER, PETROCHEMICAL )

(125 of 2011, SPPU)

DECLARATION

I hereby declare that I have gone through the Syllabus and the list of books
prescribed for the examination for which I am appearing.
I shall be responsible for any errors and wrong or incomplete entries made by me
in the examination form.
I shall not request for special concession such as change in the time and/or day
fixed for the University examination etc. on religious or any other grounds.

Yours faithfully

Note : The form should be verified by the class teacher & signed. Please, Select
elective subject(s) carefully, because elective subject(s) are not editable.

Place : _______________

Date : _______________ Signature of the Candidate

Verified by class teacher

Stamp & Signature of the Principal