ME ADMISSION 2012-13 Prospectus - K. K. Wagh Education Society

PROFORMA: 1
Specimen application form for cancellation of admission:
(To be submitted in duplicate)
To,
The Principal,
K. K. Wagh Institute of Engineering Education & Research,
Nashik
Date:
Sir,
Full name of Candidate: _____________________________________________
Name of Department (Admitted):______________________________________
Program: ________________________ Date of admission: __________________
Category of seat (sponsored/Non sponsored): ____________________________
Amount of fees paid: Rs _____________________________________________
Receipt Number and Date: _______________________ (attach Xerox-copy)
Undertaking:
I am fully aware that after cancellation, I forfeit my claim on admission in any round by Competent
Authority. Please refund the amount due to me after deducting the cancellation charges by
Cheque /DD.
I request you to kindly return my original documents.
_____________________
Signature of candidate
Received following original documents from the admission authority.
1.
2.
3.
4.
Signature of the Candidate
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