BRANCH: BATCH: SECTION: GROUP:

Total No. of Students in Group:

Total No. of Boys:

Total No. of Girls:

Boys: In campus ………………….. Outside campus:……………………

Girls: In campus…………………… Outside campus:……………………

Total No. of day scholar (including Boys + Girls):-

Total No. of Hostler (including Boys + girls):-

Total No. of students using bus facilities:

Boys:

Girls:

Class representative Name:…………………………..

Mentor Name…………………………………………
 INFORMATION HANDBOOK FOR MENTORING

BATCH……………………….. DEPARTMENT……………………
NAME………………………………………………… SEX (M/F)………………….
E MAIL……………………………….…………….. BLOOD GROUP……………
UID………………………………………………..
CATEGORY (please tick) (GEN / SC/ST/OBC/ NOT MENTIONED)………………….
SEM………………………………………YEAR 1ST….2ND …..3RD ……4TH……….
(PLEASE TICK)
Section……………… Group………………… DOB………………………………
FATHER’S NAME……………………………………………..
OCCUPATION………..…………………………DESIGNATION…………………….
OFFICE ADDRESS………………………………………………………………………
OFFICE PHONE NO……………………………………MOBILE NO…………………
MOTHER NAME……………………………………….
OCCUPATION…………………………………DESIGNATION………………………
OFFICE PHONE NO…………………………..MOBILE NO………………………….
WHETHER THE STUDENT IS STAYING IN HOSTEL? YES/NO……………………
PRESENT ADDRESS…………………………………………....................................
…………………………………………………………………………………………….
…………………………………………………………………………………………….
…………........DISTRICT………………..STATE…………………..PIN…………………..
STD CODE…………………..PHONE NO………………………………………………
CORRESPONDENCE ADDRESS……………………………………………………..
…………………………………………………………………………………………….
…………………DISTRICT………………………STATE………………………PIN……..
STD CODE………………….STATE…………………….PIN………………………….
GUARDIAN NAME (If any)……………………………………………………………
OCCUPATION………………………………..DESIGNATION………………………..
OFFICE ADDRESS…………………………………………………………………….
…………………………………………………………………………………………….
OFFICE PHONE NO……………………………MOBILE NO…………………………
WHETHER THE STUDENT IS USING COLLEGE BUS FACILITY? YES/NO…….
UNIVERSITY RESULT (use pencil for filling this page)
 RESULTS

Marks in 10th with Board……….

Marks in 12th with Board…..…..

Result From UIMS

ATTENDANCE RECORD FROM UIMS
 CONVERSATION WITH PARENTS RECORD

Date Type of Person with Topic of Type of Any Signature

conversatio whom conversation informatio suggestio
n talked to n you n from the
(telephonic / provided parents
Personal)
 ACHIEVEMENTS IN UNIVERSITY

Students Area of Field of Level of Date Prize if any

Name achievement achievement competition
 MENTOR ACTIVITIES

Sr. No. Type of activities Schedule date Status

 INTERACTION WITH STUDENTS

Date Points Discussed Name of Signature of

students Present Students

FORTNIGHT ATTENDANCE
(From UIMS)

1. List of students with attendance below 75% attendance & action taken record.
 2. List of students with attendance below 65% attendance & action taken record.
3. List of students with attendance below 50% attendance & action taken record.

MST, record & analysis and action taken for slow learners and
advanced learners: