Shri Shivaji Science College, Amravati
2019-2020
Email address *
Career Counseling Cell - Registration Form
Dear Students, All the fields in the registration form are compulsory. After submission of this form, you need to deposit registration fees of Rs. 100/- with Prof. Kirtidwaj Gawai, Deptt. of Environmental Science to confirm your enrollment. Please check your message appearing after successful submission. The copy of the form will be mailed to you as a receipt of registration form.
Your College ID (Roll No) *
Your answer
Surname *
Your answer
First name *
Your answer
Father's name *
Your answer
GENDER *
DATE OF BIRTH
MM
/
DD
/
YYYY
Category *
Class *
YEAR *
Subject Group (like Bio, PCM, CSM, BTB, etc.) *
Your answer
Mobile No. *
Your answer
BLOOD GROUP *
RH FACTOR *
PREVIOUS EXAMINATION *
PERCENTAGE / GRADE OBTAINED IN PREVIOUS EXAM
Your answer
Declaration
I hereby declare that all the statements made by me in the registration form are true and complete to the best of my knowledge and belief and nothing has been concealed or suppressed. I also understand that in enrollment for this cell compel me to regular participation in activities. I will always convey my career achievements to the college.
A copy of your responses will be emailed to the address you provided.
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