Application for Duplicate Registration Card
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Transcript of Application for Duplicate Registration Card
Form No. : ACA-05
BIJU PATNAIK UNIVERSITY OF TECHNOLOGY, ORISSA
ROURKELA
APPLICATION FOR DUPLICATE REGISTRATION CARD
Instructions : (i) Application shall be forwarded by the Principal / Director of the respective college
specifying the reason for Duplicate Registration Card.with Official Seal.
(ii) The application shall be accompained by the Original FIR of Police Station where
the Registration Card has lost / damaged.
(iii) Fees of Rs.100/- in shape of Demand draft in favour of Biju Patnaik University of
Technology payable at Bhubaneswar is to be attached.
A. Name of the College : .............................................................
B. Registration Number : .............................................................
C. Name of the student : .............................................................
D. Discipline : .............................................................
E. Branch : .............................................................
F. Demant Draft Details
(a) Amount : Rs.100/- (rupees one hundred only).
(b) DD. No. : .................. (c) DD. Date : ..................................
(d) Bank : ....................................................................................
Date : ............................ Signature of the Student
Forwarded to the UniversityLetter No................... date : .......................
Principal / Director
For University office Use Only
Academic Section : Issue / Do not issue
Registrar