GUJARAT UNIVERSITY

Registration of Students Representative

In formation in respect of the Students Voter for the year 2016-17

Election of Students Representative on the Court of the University in accordance with the Statute 14-C

1. Voter's Faculty	2. Birth Date								3. Coll Code
	D D		M M		Y Y Y Y
UG Arts	0	0	0	0	0	0	0	0	0	0	0
UG Commerce	1	1	1	1	1	1	1	1	1	1	1
UG Science	2	2	2	2	2	2	2	2	2	2	2
PG Arts	3	3	3	3	3	3	3	3	3	3	3
PG Commerce	4	4	4	4	4	4	4	4	4	4	4
PG Science	5	5	5	5	5	5	5	5	5	5	5
Law	6	6	6	6	6	6	6	6	6	6	6
Medicine	7	7	7	7	7	7	7	7	7	7	7
Education	8	8	8	8	8	8	8	8	8	8	8
Dental Surgery	9	9	9	9	9	9	9	9	9	9	9
Age as on 30-09-2016
Year Month Days

DO NOT PIN / STAPLE

The Photograph

Paste the photograph
inside the box only

Student Signature

Name of the College : Uni. Department if Any : The Class and the year in which the Voter is at
Present Studying :

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5. Full Address 6. Mobile No: