PROFORMA FOR NOMINATION OF BEST OUTGOING STUDENT AWARD

1. NAME :

2. REG. No. :

3. PROGRAMME :

4. BRANCH :

5. SCHOOL

6. BANK ACCOUNT DETAILS

AT VIT INDIAN BANK :
:
7. CONTACT ADDRESS :

a) Present Address with Phone No. :

(From to )

b) Permanent Address with Phone No. :

(with STD code)

c) Email ID :

d) Mobile No. :

8. ACADEMIC PERFORMANCE :

SEMESTER GPA SEMESTER GPA

I V
II VI
III VII
IV IX
X
CGPA Total

9. a) PLACE OF PROJECT:

S.No Title of the Project Place of Project Remarks

. Address for
Communication
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 b) PROJECT DETAILS (Describe about 200 words) (Enclose a separate sheet)

10. ARE YOU REGISTERED WITH VIT PAT : YES/NO

OFF CAMPUS PLACEMENT :

IN CAMPUS PLACEMENT DETAILS (NAME ALL THE INTERVIEWS ATTENDED)

S.No. Name of the company Remarks Selected Dream Offer

i.

ii.

iii.

iv.

10. PARTICIPATION IN CO & EXTRA CURRICULAR ACTIVITIES

I. Member of Students’ Chapter (Duration / Year)

a)

b)

c)

II. Member of Students’ Club (Duration / Year)

a)

b)

c)

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III. 11. Participation in Co & Extra-Curricular Activities & Prizes Won (Duration / Year)

I. Students’ Chapter

a)

b)

c)

II. Students’ Club

a)

b)

c)

12. Administrative Achievement - Students Council, Class Representatives, President of Students Chapters

& Clubs ( Please Mention the Year & Duration)

a)

b)

c)

d)

e)

f)

g)

h)

13. Academic Achievements (Endowment Awards, Scholarships, Papers Presented in National &
International)

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 14. Sports Achievements (Duration / Year)
a. Intramurals

b. Outside VIT (TIES Etc.)

15. Details Of Competitive Examination

S.No. Name of the Exam Score Year of Remarks
appearance
1. CAT (Common Aptitude Test)

2. MAT

3. GATE

4. G-MAT

5. GRE

6. IELTS
(International English Language Testing
System)
7. TOEFL

8. BEC

9. NET, SLET, IAS, Defence Entrance,

Other services, Any other (specify)

10.

16. PROFICIENCY IN LANGUAGE (Please underline Mother Tongue)

S.No Language Speak Read Write

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.
1.

2.

3.

4.

5.

17. ADMISSION FOR HIGHER STUDIES (NATIONAL /INTERNATIONAL)

18. DETAILS OF ANY SPECIAL ACHIEVEMENTS (Enclose extra sheet if required)

19. ANY OTHER RELEVANT DETAILS YOU WANT ADD: (Enclose extra sheet if required)

20. PROGRAMME CHAIR REPORT:

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 Mr./Ms. ………………………………………………………… Registration No……………… is a

nominee for best outgoing student award. This confidential Report may be submitted to Director Students’

Welfare in a sealed cover, with name of student written on the cover.]

Signature: Name In Capital Letter: Designation:

21. PROCTOR’S RECOMENDATION

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 Mr./Ms. ………………………………………………………… Registration No……………… is a

nominee for best outgoing student award. This confidential Report may be submitted to Director, Students’

Welfare in a sealed cover, with name of student written on the cover.]

Signature: Name In Capital Letter: Designation:

22. DEANS RECOMENDATION:

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 Mr./Ms. ………………………………………………………… Registration No……………… is a

nominee for best outgoing student award. This confidential Report may be submitted to Director , Students’

Welfare in a sealed cover, with name of student written on the cover.]

Signature: Name In Capital Letter: Designation:

 Please submit the enclosed recommendation letter from the School Director, Programme Manager,
Project Guide and Proctor directly to Director, Students’ Welfare, VIT University.

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23. DECLARATION:

I certify that the information furnished above factually correct and subject to verification. All the details given are
true to best of my knowledge.

(Signature of the Student)

Name In Capital Letter :

Registration No. :

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