Netaji Subhash Engineering College 

Department of Mechanical Engineering 

Student Name:
Department:
Name of the Mentor:

1. Student Basic Information

Identity Card Land line No.
Name Mobile No.
Date of Birth Email Id.
N Blood Group WBUT Reg. No.
Guardian Name Year:
WBUT Roll No.
Local Guardian Stream
Permanent Address Batch
Diploma Score
(if any)

Local Address AIEEE/ WBJEE

Rank (if any)

Medium of Education Medium of

(10​th ​) Education (12​th ​)
Name of School Name of School

Score in 10​th ​Class Score in 12​th

Year of Passing Year of Passing
Marks in 12​th ​Class: Mathematics: Physics: Chemistry:
Academic achievements (if any)*

*Attach separate sheet if required

 2. Semester wise academic details during Graduation
1​st ​Semester 2​nd ​Semester

Highest Score in Class Highest Score in Class

Attendance (Average) in Theory Attendance (Average) in Theory

Attendance (Average) in Lab. Attendance (Average) in Lab.

Any disciplinary action Any disciplinary action

Theory Theory

Grade Grade

Lab. Lab.

Grade Grade

SGPA: SGPA:

Subjective judgment​(Good/Avg./Poor) Subjective judgment ​(Good/Avg./Poor)

3​rd ​Semester 4​th ​Semester

Highest Score in Class Highest Score in Class

Attendance (Average) in Theory Attendance (Average) in Theory

Attendance (Average) in Lab. Attendance (Average) in Lab.

Any disciplinary action Any disciplinary action

Theory Theory

Grade Grade

Lab. Lab.

Grade Grade

SGPA: SGPA:

Subjective judgment ​(Good/Avg./Poor) Subjective judgment ​(Good/Avg./Poor)

 5​th ​Semester 6​th ​Semester

Highest Score in Class Highest Score in Class

Attendance (Average) in Theory Attendance (Average) in Theory

Attendance (Average) in Lab. Attendance (Average) in Lab.

Any disciplinary action Any disciplinary action

Theory Theory

Grade Grade

Lab. Lab.

Grade Grade

SGPA: SGPA:

Subjective judgment ​(Good/Avg./Poor) Subjective judgment ​(Good/Avg./Poor)

7​th ​Semester 8​th ​Semester

Highest Score in Class Highest Score in Class

Attendance (Average) in Theory Attendance (Average) in Theory

Attendance (Average) in Lab. Attendance (Average) in Lab.

Any disciplinary action Any disciplinary action

Theory Theory

Grade Grade

Lab. Lab.

Grade Grade

SGPA: SGPA:

Subjective judgment ​(Good/Avg./Poor) Subjective judgment ​(Good/Avg./Poor)

 3. Activities Beyond Curriculum*
Activities Contribution
Soft skill class attended
Aptitude class attended
Industrial training I
Industrial training II
Online test
GATE Examination
CAT/MAT/JEMAT Examination
Arranged/Participated in Cultural Fest
Arranged/Participated in Technical Fest
Seminar/Workshop attended
Certifications/Courses
Contribution to Annual Magazine
Contribution to Wall Magazine
Technical contest (e.g. Phoenix)
Attendance in On Campus interview
Attendance in Off Campus interview
Paper publications
Awards/ Scholarship received
*Attach separate sheet if required

4. Details of counseling and Mentor comments

Date Semester Comments by Mentor**

** See reference sheet to read the Check-Points