5/23/2016

ShriGovindramSeksariaInstituteofTechnologyandScience,Indore

CounselingHome
PrintApplicationFormForP.G.Courses(M.E./M.Tech./M.Sc./M.PHARM.)20162017

ApplicationNo. :

GS16EI1044

Mobile :

7509781787

DateofBirth

24/12/1992

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ShriGovindramSeksariaInstituteofTechnologyandScience
Indore,MadhyaPradesh
23,ParkRoad,Indore

APPLICATIONFORMPRINT
ApplicationDetails
QualifyingExam&Branch

BE/B.TechElectrical&Electronics
Engineering

OBC/X

Domicile

No

UserName

AYUPATIDAR

GateStatus

GATEQualified

QualifyingMarks

29.90

QualifyingYear

2015

Gate/GPATScore

417.00

ApplicationDate

23/05/2016

RegistrationNumber

GS16EI1044

AppliedCourse

M.E./M.Tech.

Category/Class
NCC'C'
Certificate(Y/N)

BranchPreferenceDetails

Branch

PreferenceOrder

(E&I)MICROELECTRONICS&VLSIDESIGN

(ELECTRICAL)POWERELECTRONICS

APPLIEDPHYSICS(OPTOELECTRONICS)OPTICAL
COMMUNICATION

PersonalDetails
ApplicantName

AAYUSHPATIDAR

DateofBirth

24/12/1992

Father'sName

JAYPRAKASHPATIDAR

Gender

Male

Correspondence
Address

89VINAYAKBHAWAN910PROFESSORCOLONYBHAWARKUANSQUARE,INDORE,Indore,M.P.452001

ContactNo.

+917509781787

MobileNo.

+917509781787

Email

ayupatidar@gmail.com

Nationality

INDIAN

QualificationDetails

NameOfCollege

Board/University

EnrollmentNo

Percentage

PassingYear

CHAMELIDEVISCHOOLOF
ENGINEERING

RAJIVGANDHIPROUDYOGIKI
VISHWAVIDYALAYA

0832EX111001

76.50

2015

ImportantInstructions
OriginalDocumentstobesubmittedatthetimeofreporting:
Marksheetofqualifyingdegree.
Marksheetsofalltheyearsofqualifyingdegree.
GATE/GPATScoreCard(whereverapplicable)
Cast&domicile,certificatesonprescribedformatofGovtofMP(forcandidatesbelongingtoScheduledCast(SC),ScheduledTribe(ST)andOtherBackwardClass
(excludingcreamylayer)(OBC),ofMadhyaPradesh).
CandidateswhohaveacquiredB.E.degreefromaselffinancedInstitution(outofM.P.)arerequiredtosubmittheproofaboutAICTEapprovaloftheInstitutefrom
theHeadoftheconcernedInstitution.
TransferCertificateandCharacterCertificatefromthePrincipaloftheCollegelastattended(maybesubmittedwithin15daysafteradmission).
MigrationCertificate(maybesubmittedwithin15daysafteradmission).
ProofofDateofBirth(likeCertificate/MarksheetofHSC/HSSCExamination).
NCCCCertificate,ifapplicable.
Tworecentpassportsizephotographs.

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5/23/2016

ShriGovindramSeksariaInstituteofTechnologyandScience,Indore

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