INDIAN INSTITUTE OF SCIENCE,

BANGALORE - 560012
APPLICATION FORM FOR ADMISSION TO

Application No

13311094

COURSE PROGRAMME (ME/ M TECH/ M DES) 2013

Name of the Candidate : (as it appears in your Degree Certificate) Gender : Category : Date of Birth : Address for Correspondence : Male Scheduled Caste 29 Feb 1992 Mr. KUNTALA RAHUL Nationality : State of Domicile : Indian Andhra Pradesh

PIN Code : E-mail Address : Phone Number :

H.No:14-10-364, Jumerath Bazar, Lower Dhoolpet, Hyderabad, Andhra Pradesh 500006 rahulkuntala9@gmail.com Mobile Number : No GATE Paper

+91 - 9395315115

Are you Currently Employed? Employed Organisation : Designation : Office Address : Work Experience : GATE Details : Year 2012 2013

GATE Roll Number CS71551204

Score (out of 1000) 374

Computer Science and Engineering

National Entrance Test Details : National Entrance Test CEED CEED Year 2012 2013 Register No. Marks (Out of 100)

Preferences of Department(s) / Discipline(s): I : COMPUTER SCIENCE AND ENGINEERING II : COMPUTATIONAL SCIENCE III : PRODUCT DESIGN AND ENGINEERING IV : TRANSPORTATION AND INFRASTRUCTURE ENGINEERING V : CLIMATE SCIENCE Educational Qualification : Schooling Year of Passing 10th Std 2007 Institution / School Good Will High School, Begumbazar,Hyd erabad Hasvita Junior College, Disluknagar,Hyde rabad Board Andhra Pradesh % of Marks 68.30 Rank Key Subjects HINDI,TELUGU,ENGLISH,SCIEN CE,SOCIAL STUDIES

12th Std

2009

Andhra Pradesh

85.90

Hindi,Sanskrit,Mathematics A,Mathematics B, Physics,Chemistry

Submitted by Mr. KUNTALA RAHUL on Mar 21 2013 3:21PM

Educational Qualification : Degree (Studying Year of Institution / University / Completed) Passing College B Tech-Computer 2013 JNTUH College Jawaharlal Nehru Science and of Technological Engineering Engineering,Nach University upally,karimnagar

Class I

Rank -

Key Subjects C,C++,JAVA,Op erating system,computer networks,CD,Net work security

Sem / Year 1 2 3 4 5 6 7 8 9 10

Marks / GPA 79.9% 63.7% 66.3% 68.3% 66.7% 63.4%

Qualifying Exam : Branch / Specialization: University : Year of Passing :

B Tech Status : Appearing/Appeared Computer Science and Engineering JNTUH College of Engineering,Nachupally,karimnagar, Jawaharlal Nehru Technological University 2013

Declaration : I Confirm that all the information which I have given in this application is complete and true to the best of my knowledge and belief. If admitted, I will be bound by the rules and regulations of the Institute. Place : Hyderabad

Date : 21/3/2013
Submitted by Mr. KUNTALA RAHUL on Mar 21 2013 3:21PM

Signature of the Applicant