Scribd
Upload
9 views

Application Form

The document is an application form for a student to appear in a 6th semester diploma examination. It collects information such as the student's name, father's name, address, institution details, subjects to appear for, previous examination details, and declarations signed by the student and principal.

Uploaded by

1234efootball
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
9 views

Application Form

The document is an application form for a student to appear in a 6th semester diploma examination. It collects information such as the student's name, father's name, address, institution details, subjects to appear for, previous examination details, and declarations signed by the student and principal.

Uploaded by

1234efootball
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

MEGHALAYA STATE COUNCIL FOR TECHNICAL EDUCATION

SHILLONG
APPLICATION FORM FOR APPEARING DIPLOMA EXAMINATION

CURRENT SEMESTER Candidate Photo


6 SEMESTER
APPEARING

BACKLOG SEMESTER
NIL
1 APPEARING

DATE OF
APPEARING AS REGULAR / 2024-05-
REGULAR EXAM TO
BACKLOG 30
BE HELD

2. BRANCH OF ENGINEERING MECHANICAL ENGINEERING


3. NAME OF THE CANDIDATE SHRI SHAIBOKLANG KHARBUDON
4. FATHER'S NAME SQUARELING KHONGJEE
5. MOTHER'S NAME JEMNUD KHARBUDON
LEGAL GUARDIAN'S NAME if
6.
parents not alive
7. SEX M DOB 2004-11-28
HOME ADDRESS FOR POST
LYNKYRDEM PYNURSLA
COMMUNICATION OFFICE
8.
PIN CODE 793110 STATE MEGHALAYA
DISTRICT EAST KHASI HILLS
NAME OF THE INSTITUTION
9 SHILLONG POLYTECHNIC
WHERE STUDIED/STUDYING
10 EXAMINATION ROLL NO. SH/M-221025
11 REGISTRATION NO. 6696 YEAR 2021
MONTH & YEAR OF
12 ADMISSION TO THE FIRST 09-2021
SEMESTER
NAME OF THE
13 SHILLONG POLYTECHNIC
POLYTECHNIC
DETAILS OF LAST EXAMINATION APPEARED (Photo copy of the marksheet to be enclosed)
Appeared Year and
Center Of
Examination Exam Roll as Regular Month of
Which Branch
14 Appeared No. / Backlog Exam
Appeared
Candidate Held
SHILLONG SH/M- MAY
6 Semester REGULAR MECHANICAL ENGINEERING
POLYTECHNIC 221025 2024
Name of the subject & subject code desire to appear in this semester examination indicating
15
Theory(Th) and Practical(Pr) seperately.
Subject
No Name of the Subject TH / PR Semester Regular / BACKLOG
Code
Plant Maintenance 6
15.1 Th ME507 Regular
Engineering Semester
Refrigeration and Air 6
15.2 Th ME509 Regular
Conditioning Semester
Refrigeration and Air 6
15.3 Pr ME509 Regular
Conditioning Semester
6
15.4 Machine Tools II Th ME502 Regular
Semester
6
15.5 Mechanical Estimation Th ME510 Regular
Semester
Nonconventional Sources of 6
15.6 Th ME602 Regular
Energy Semester
Nonconventional Sources of 6
15.7 Pr ME602 Regular
Energy Semester
6
15.8 Project Pr ME516 Regular
Semester
6
15.9 Professional Practices V Pr ME515 Regular
Semester
16 SBCollect Reference Number DUM6065669
Signature of the Candidate
To,
The Secretary,
Meghalaya State Council For Technical Education,
Shillong,
(Through the Principal Shillong Polytechnic Shillong)
Sir/Madam,

I Request your honour to kindly grant me permission in appear at the ensuing 6


Semester NIL Diploma Examination to be held in 2024-05-30 as a REGULAR candidates.
Necessary fees as follows has been paid at the office of the principal Shillong Polytechnic
Shillong (Receipt attached)
1. Examination Fees(Inclusive of Marksheet Fee) Rs.
2. Permission Fee (as applicable in case of non-collegiate candidate) Rs.

DECLARATION BY THE CANDIDATE

I hereby solemnly and sincerely affirm that the statement made and information
furnished by me in the Application Form is true and correct. I have not concealed any
information. However, if any information furnished herein fraudulent, incorrect or untrue
if its appear that in the opinion of the Council, I have any way contravened the provision
of the Council's Rules and Regulation relating in the Examination, my admission to the
Examination shall liable to be cancelled by the Council. I agree to abide by the Rules and
Regulation relating to the Examination of Meghalaya State Council For Technical
Education Shillong.

CERTIFICATE FROM PRINCIPAL

I Certify that Shri/Smti SHRI SHAIBOKLANG KHARBUDON has fulfilled the


requirements necessary to be eligible to appear in 6 Semester NIL Examination of three
years Diploma course to be held in 2024-05-30 as Regular (Collegiate / Non Collegiate) /
backlog candidate and has completed the prescribed course of study for the examination
and secured the minimum pass mark in internal evaluation in each subject prescribed for
the course of study and that his / her conduct and character has been satisfactory.

Principal
Seal of the Institution

FOR OFFICE USE

Allowed / Disallowed to appear ________________________________________________ if


disallowed reason for disallowing ___________________________________________________

Signature of Secretary
Meghalaya State Council for Technical Education
Shillong

Examination Roll No. as per Admit Card.____________________________

Signature of dealing Assistant

Date: _____________________________

Print Close

You might also like