Print Date and Time 14/11/2024
Enrollment Letter
Form of application for enrollment as a student of the University
No Candidate reading in the recognized college of university shall be Enrolled as student of the University unless he/she
produces as eligilibty certificate issued by the University along with this application. If he/she is an immigrant from a
University or Board (other than the board of Secondary Education, Rajasthan, Ajmer) Incomplete application will in case
be Private Candidates are not required to produce eligibility certificate.
To
The Registrar
MBM University
Jodhpur
Form No : 12106969
Sir,
I request that I am be enrolled as a student of the University. The particular as given below.
1. Registration No. : J23U510851
2. Form No. : 12106969
3. Application Name : MUMTAJ ALI ANSARI
4. Father's Name : SAMA ALI ANSARI
5. Mother's Name : FATIMA KHATOON
6. Date of Birth : 01/08/2002
7. Class in which admitted : B.E.(CBCS) ENGINEERING Ist SEM-- ( DEPARTMENT
OF MECHANICAL ENGINEERING )
8. Subject : Civil Engineering
9. Category : REGULAR
10. Date of admission in the institution :
11. Name of Last qualifying examination passed : 12th
12. Year and Roll No. of passing the above Examination : 2021 Roll No. :
13. (a) Name of the Board or University Last attened : Rajasthan Board of Secondary Education, Ajmer-305
001.( 2021 )
(b) Result wether pass/Failed :
(c) Enrollment/Roll No. Number thereat/ :
14. Name of the institution form which passed (If passed as :
regular or ex-student )
15. Number and date of the eligibility certificate / (In case of :
the candidates wh have migrated from other Universities
issued by the University)
16. Address of the Applicant
(i) Permanent Address : D176 MURLIPURA SCHEME JAIPUR
(ii) Local Address : D176 MURLIPURA SCHEME JAIPUR
Signature of the Candidate
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