TEZPUR UNIVERSITY
COURSE WITHDRAWAL / REGISTRATION FORM
(To be submitted to the Office of the Controller of Examinations on or before the date specified in the Academic Calendar)

1. Please use capital letter while filling name, programme etc.. Please write only one alphabet or digit in one box in the column provided for course codes. Please write codes and title neatly.
2. Please mark clearly ‘C’ for core course,’E’ for Elective course,’A’ for Audit course in ‘ course type’ column.
3. Please fill in all the columns. Student shall be solely responsible for the accuracy of the information provided. Incomplete or incorrect information could be of disadvantage to the student in the evaluation of performance.

Name………………………………………………………………………………….Roll no…………………………….

Programme…………………………Department…………………….Semester no…….Autumn/Spring 200………

Previous Semester record (s) SGPA : CGPA

Please state reason(s) for withdrawal: ……………………………………………………………………………….…

…………………………………………………………………………………………………………………………………

Courses withdrawn:

Course code
Course title Credit Course type Specialization Signature of course Instructor in every course

Course proposed to be registered:

Course code
Course title Credit Course type Specialization Signature of course Instructor in every course

Date. Signature of the Student

Forwarded by the Course advisor/ supervisor

Recommendation of the Head of the Department

The above mentioned student is allowed to withdraw from the course stated above and register another course in the Autumn/ Spring Semester 200….

Date. Head, Department of …………