INTERNET FACILITY
Tezpur University
Napaam::784028 (Assam)
Application for E-mail & Internet Account

1. Name (Mr./Ms./Dr.)

2. Designation

3. Department

4. E-mail /internet account name
(Max. 7 characters all in small letters) :

5. Password ( Max 7 Characters)

Signature of Head of the Deptt. With Seal Signature of the Applicant

_____________________________________________________________________________________________
For Office Use only

Account Created Yes/No

Password Allotted Yes/No

Date Created (DD/MM/YYYY

Remarks: Signature of In charge
Internet Facility