4223132 (1)

8/10/2019 4223132 (1)

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Personal Details

Name of Candidate:

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Name :Mother's Name:

Date of Birth: Candidate Gender:

Categor:!tate/Union "erritor of

Caste/"ribe:

!erial Number of #aste/"ribe: Caste/"ribe Name:

Nationalit: $ther Nationalit:

Person %ith Disabilit/Differentl

&bled P(D/D&):P(D/D& Categor:

Disabilit Per#entage:Do ou re*uire %heel#hair

su++ort at the test #entre,:

Communi#ation &ddress

&ddress :

!tate/Union "erritor: $ther !tate/Union "erritor:

Countr: $ther Countr:

Cit: Pin Code:

Mobile Number: -mail &ddress:

Mobile Number &lternate) : -mail &ddress &lternate) :

-.am Centre Cit Preferen#es

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Preferred Cit 1:

&#ademi#s Details

!!C/2th !td/-*ui3alent Details

&ggregate mar4s: Month/5ear of Com+letion:

!#hool Name:

!!C/2th !td/-*ui3alent Board

Name

$ther Board Name:

4223132

KUMAR ABHISHEK

JAGDISH KUMAR SHAKUNTALA DEVI

Male

SC Uttar Pradesh

24 CHAMAR

Indian

No

N-353 AASHIANA

NEAR PASI QUILA

Uttar Pradesh

India

226012LUCKNOW

9044512336 [email protected]

Kanpur

Lucknow

New Delhi

86.80 May 2008

CENTRAL ACADEMY

Central Board of Secondary Education

8/10/2019 4223132 (1)


H!C/0th/-*ui3alent/Di+loma Course Details

Course "+e: &ggregate Mar4s:

0th/-*ui3alent Board Name:

$ther Board Name:

Uni3ersit/Board/$ther &uthorit

Name:

College/Institute Name:

Dis#i+line: $ther Dis#i+line Name:

Month/5ear of Course

Commen#ement:Month/5ear of Com+letion:

Ba#helor Degree Details

&re ou in the final ear of Ba#helor Degree,

Ha3e ou #om+leted Ba#helor

Degree,"otal Duration of Degree:

Current !emester: &ggregate Mar4s:

"+e of Uni3ersit/Institution:$ther "+e of Uni3ersit/

Institution:

!tate/Union "erritor (here

Uni3ersit is !ituated:

$ther !tate/Union

"erritor (here Uni3ersit

is !ituated:

Uni3ersit Name:

Name of College/Institution:

Degree Name:

$ther Degree Name:

Dis#i+line:

$ther Dis#i+line Name:



$ther Professional Degree Details

Ha3e ou #om+leted an +rofessional degree su#h as C&/C!/IC(&

%ithout #om+leting Ba#helor's Degree:

!ele#t the Degree:

!+e#if $ther Professional

Degree:

Professional Inter Mar4s: Professional Final Mar4s:



HSC 87.80

Central Board of Secondary Education

CENTRAL ACADEMY

Mathematics and Science

2010May

Yes

4 Year

Semester-7 71.11

State University

Uttar Pradesh

UTTAR PRADESH TECHNICAL UNIVERSITY

HARCOURT BUTLER TECHNOLOGICAL INSTITUTE

B.Tech

Engineering/Technology

JulyAugust 2011 2015

No

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Master Degree Details

Do ou %ant to enter Master

Degree Details,

Master Degree Com+letion !tatus: Duration:

Current !emester: &ggregate Mar4s:

"+e of Uni3ersit/Institution:$ther "+e of

Uni3ersit/Institution:

!tate/Union "erritor of

Uni3ersit:

$ther !tate/Union

"erritor of Uni3ersit:

Uni3ersit Name:

Name of College/Institution:

Degree Name: $ther Degree Name:

Dis#i+line:

$ther Dis#i+line Name:



(or4 -.+erien#e Details

&utomobiles/&uto6an#illaries Ban4ing/Finan#ial !er3i#es

Durables -ngineering/Industrial

Fast Mo3ing Consumer Goods

FMCG)Information "e#hnolog

Pharma#euti#als/Health#are 7etail

"ele#ommuni#ations

$thers

$thers0

$thers1

No

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Programme Details

IIM &hmedabad PGP IIM &hmedabad PGP6&BM

IIM &hmedabad FPM IIM Bangalore PGP

IIM Bangalore PGP -M IIM Bangalore PGP PM

IIM Bangalore FPM IIM Cal#utta PGP6PGDM

IIM Cal#utta FPM IIM Indore PGP

IIM Indore PGM Mumbai IIM Indore PGP U&-

IIM Indore -PGP IIM Indore FPM

IIM 8ashi+ur PGP IIM 8ashi+ur -PGP

IIM 8ashi+ur -FPM IIM 8o9hi4ode PGP

IIM 8o9hi4ode FPM IIM u#4no% PGP

IIM u#4no% PGP6&BM IIM u#4no% PGP!M

IIM u#4no% FPM IIM 7ai+ur PGP

IIM 7ai+ur FPM IIM 7ai+ur PGP(-

IIM 7ai+ur -FPM IIM 7an#hi PGDM

IIM 7an#hi FPM IIM 7an#hi PGDH7M

IIM 7ohta4 PGP IIM 7ohta4 FPM

7GIIM !hillong PGP 7GIIM !hillong FPM

7GIIM !hillong PGP6-; IIM "iru#hira++alli PGP

IIM "iru#hira++alli PGPH7M IIM "iru#hira++alli PGPBM

IIM "iru#hira++alli FPM IIM Udai+ur PGP

IIM Udai+ur FPM

&++ling for the Pro+osed Ne% IIMs

IIM in &ndhra Pradesh PGP

IIM in Bihar PGP

IIM in Hima#hal Pradesh PGP

IIM in Maharashtra PGP

IIM in $disha PGP

IIM in Pun<ab PGP

KolkataKolkata

Ahmedabad Kolkata

Ban alore Ban alore

Ban alore Kolkata

Kolkata Kolkata

Kolkata Kolkata

Kolkata Indore

Kolkata Kashi ur

Kashi ur Kolkata

Kozhikode Kolkata

Kolkata Kolkata

Lucknow Kolkata

Rai ur Rai ur

Rai ur Kolkata

Ranchi Kolkata

Kolkata Rohtak

Kolkata Shillon

KolkataGuwahati

Chennai Chennai

Tiruchira alli Kolkata

Udai ur

Yes

Yes

Yes

Yes

Yes

Yes

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D-C&7&"I$N

I hereby certify tht the !rtic"#r$ %i&e' by (e i' thi$ A!!#icti)' F)r( re tr"e t) (y *')+#e,%e ', be#ief. I certify tht I f"#fi## theCAT -/0 e#i%ibi#ity criteri ', "',ert*e t) !r),"ce )ri%i'# ,)c"(e't$ +he'e&er 'ece$$ry ', I +i## ')t ,e(', 'y re$che,"#e )fe1(. I "',er$t', ## ,i$!"te$ +i## be $"b2ect t) territ)ri# 2"ri$,icti)' )f city )f I',)re )'#y.

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4223132 (1)

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