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Student Data Collection Form

Name:
EmailID:

MobileNumber:

CountryInterested:
Age:

CurrentLocation:
PreferredIntake(Intakeisnotguaranteed)

%/Grade/

GPA

Academics:
Course/Nameof
University

Degree

ModeofStudy

CourseDuration
(FromTo)

Backlogs(indicate
year/semester
wise)

[Full/Distance]

Masters

(ifyouhaveany)
Bachelors/B.
Tech

Intermediate/

12thStandard
SSC

(10thStandard)

Ifnottakenyet,
pleaseMention
expectedScore

Testdetails:
ActualScore
TestType

Status

TOEFL

Testdate

TOEFL/IELTS
IELTS

GRE
GRE/GMAT

Total

Listening

Total

Writing

Speaking

Quant

Verbal

Reading

AW

Overall

GMAT

SAT/ACT

(Indicatesectionwisescores)
Listening Writing Speaking Reading

SAT

ACT

DoyouwishtowritetheTestsagain,Ifthescores

arebelowtherequirementoftheuniversity:YES/NO:
IfNODoyouwishtoapplywithsamescores:YES/NO:

Whatisyourbudgettostudyabroad?:

*WewilltrytomapUniversitieswithintheplannedbudgetbutcannotassureonthis.
Information:
Course
Preferencewith
specializations(be
University/Collegepreference
specific)durationof
thecourse
Option:2
Option:2

LocationPreference

Option:3

SpecialNote:Workexperience(ifany):
CompanyName
Designation

Duration(FromDateToDate)

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