Regency Institute of Technology

Yanam - 533 464

Registration Form

For Admission to Graduation Day

Name Of the Candidate (As per SSC)

Registration No

Particulars of the Examination Passed   Course       Branch


Contact Address:



Contact Telephone Number:                Land line:

        Mobile:

Email Id:

Prescribed for receiving the degree:  500

(To pay at the Venue in the College)


Accommodation:    Yes/No


Station:

Date: