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5 eHorockarn
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(deemed to be UNIVERSITY)
RSITY)
REQUEST FOR NOMINATION AS AN OFFICE-BEARER 2023-24
Name
Class Enrol. No.
Mother's Name
Father's Name
Postal Address
Pin
Tel.No. ®) (Mobile)
Email Address
Examination Last Passed and Percentage Obtained
Name of the School/ College
lastattended
Areas of interest
Did you participate in the preliminary round of Ms. Fresher Contest? Ifnot why ?
Distinguised achievement in the past
Have you held any post in the past in the IIS (deemed to be University) Council. If yes, Mention your post
and contribution to the same
Dated Signature
Recommendation of the Student's Welfare Committee
LO Good Livery Good 1 Outstanding
Any other comments
Gurukul Marg_= SFS = Mansarovar = Jaipur 302 020 = Rajasthan = INDIA
Tel : +91-141-2400160-161 a Fax: +91-141-2395494 m Email :ieg@ilsunivac.in = Web : wwwiisunivacin