Application For Supplementary Examination July/August 2015

Name of the Candidate : _____________________________________________________

Reg No/Semester/Branch

Eligibility: Only candidates having backlog papers with F & I grade can apply.

: ________________ / __________ / __________________

Details of subjects applied with Subject Code & Title:

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Sl. No.
Subject Code
Subject Title
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Last Date of Application (Both Online/Offline): 10th July 2015 (Online forms shall be
available in our official website of SMIT (smu.edu.in/smit.html) from 25th June 2015)
Communication Address (Compulsory):
Email ID: _________________________________ Phone No: ________________________
No. of backlog subjects to be cleared: _____ Mention the subject code: ________________
____________________________________________________________________________

For Direct online Deposit of Money:

(a) Name of Account holder: Sikkim Manipal Institute of Technology
(b) Account No: SB A/c No. 441010100069632
(c) IFSC Code: UTIB 0000441
(d) Bank Code: 211 (AXIS BANK)
Mandatory instruction for online deposit.
(a) Registration No
(b) Name of Student (in BLOCK LETTERS Only)
(Student should ensure that Bank must enter Registration No. & Student Name)

Application forms will be accepted only if

(a) Filled in form is complete in all respects.
(b) Proof of bank deposit slip/Transaction details for online transfer/DD should reach SMIT on or
before 10th July 2015. Fee once deposited is not refundable under any circumstances.
10 Email should be sent to the following ID with an attachment of Form and Fee receipt:
(a) dce.tech.smit@gmail.com
10 Fees (Nonrefundable) for Supplementary Exam: UG/PG Rs 1000/- per paper.
Signature of Candidate