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Notice 1721131225

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VEER SURENDRA SAI UNIVERSITY OF TECHNOLOGY: BURLA

FORM NO. (ACADEMIC): E

No.VSSUT/ / /20……. Dated: ….../……./20…….

APPLICATION FORM FOR RE-ADMISSION


1. Full Name (in Block Capital Letters): __________________________________________
2. Registration No_______________3. Programme______________4. Semester ________
5. Branch _________________________________ 6. Student Mobile No.______________
7. Semester to which to be admitted ______ 8. (i) Regular / Self Sustaining______________
(ii) Day Scholar: Yes / No ___________
9. Notification No. & date of year drop / Admission cancellation_______________________
10. Reason for Year Drop/ Registration Cancellation (tick the reason)
a) Failure to clear theory backlog
b) Failure to clear Lab / Sessional papers
c) Failure to register for non-payment of dues
d) Failure due to shortage of attendance
e) Failure to register due to long illness
f) Any other (mention reason)
11. Whether paid all the arrear dues of the University up to date _______________________
12. Enclosures:
a) Copy of University Registration Card
b) Copy of money receipt of last semester
c) Copy of Grade Sheet of the semester at the time of year drop
d) Copy of the Grade Sheet of the examination last appeared

Date……………………….. Full Signature of the student


Place……………………….

FOR OFFICE USE


On verification of relevant records and original documents, the above student is found eligible
for Re- admission to _______Semester of B.Tech / B.Arch / B.Tech & M.Tech Dual Degree
20………….

Dealing Assistant Section Officer

Allowed / Not to be Allowed

Dean, Academic Affairs / Dean, PGS & R


N.B: 1) A student is not allowed to take re-admission after 08 years (in case of B.Tech), 07
years (in case of B.Tech- LE), 10 years (in case of B.Arch), 04 years (in case of MCA /
M.Tech / M.Sc.) and 10 years (in case of 5 yrs Int. M.Sc.)of his / her first Admission /
Registration to this University.

2) After issue of notice for re-admission, student needs to deposit the readmission fee of
₹1000/- in the University Cash Counter or Canara Bank,VSSUT Branch Burla.

3) After payment of Re-admission fee and issue notice for registration, the student need
to pay the semester registration dues as applicable and fill up the subject registration
form duly countersigned by the concerned HOD.

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