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    Application Form For M.Tech./M.Pharm. Programme: 1. Personal Information

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    rohit
    Rinku Prasad has applied for the M.Tech program in Chemical Engineering at the Department of Chemical Engineering & Technology. He has submitted his application on May 05, 2017 at 5:09PM. He is currently appearing for his BTech degree in Chemical Engineering from HBTU and has secured a GATE rank of 1941 in Chemical Engineering in 2017. He is an Indian citizen from Uttar Pradesh with no physical disabilities and is seeking institute assistantship as he requires financial assistance for the program. He has declared that the information provided in the application is true to the best of his knowledge.

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    Application Form For M.Tech./M.Pharm. Programme: 1. Personal Information

    Uploaded by

    rohit
    39 views2 pages
    Rinku Prasad has applied for the M.Tech program in Chemical Engineering at the Department of Chemical Engineering & Technology. He has submitted his application on May 05, 2017 at 5:09PM. He is currently appearing for his BTech degree in Chemical Engineering from HBTU and has secured a GATE rank of 1941 in Chemical Engineering in 2017. He is an Indian citizen from Uttar Pradesh with no physical disabilities and is seeking institute assistantship as he requires financial assistance for the program. He has declared that the information provided in the application is true to the best of his knowledge.

    Original Description:

    GATE SCORE

    Original Title

    Rinku

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    Rinku Prasad has applied for the M.Tech program in Chemical Engineering at the Department of Chemical Engineering & Technology. He has submitted his application on May 05, 2017 at 5:09PM. He is currently appearing for his BTech degree in Chemical Engineering from HBTU and has secured a GATE rank of 1941 in Chemical Engineering in 2017. He is an Indian citizen from Uttar Pradesh with no physical disabilities and is seeking institute assistantship as he requires financial assistance for the program. He has declared that the information provided in the application is true to the best of his knowledge.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    39 views2 pages

    Application Form For M.Tech./M.Pharm. Programme: 1. Personal Information

    Uploaded by

    rohit
    Rinku Prasad has applied for the M.Tech program in Chemical Engineering at the Department of Chemical Engineering & Technology. He has submitted his application on May 05, 2017 at 5:09PM. He is currently appearing for his BTech degree in Chemical Engineering from HBTU and has secured a GATE rank of 1941 in Chemical Engineering in 2017. He is an Indian citizen from Uttar Pradesh with no physical disabilities and is seeking institute assistantship as he requires financial assistance for the program. He has declared that the information provided in the application is true to the best of his knowledge.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Application Form for M.Tech./M.Pharm.

    Programme

    Application No.: 17110680


    Date & Time of Submission: 05:09PM on May 05, 2017

    1. Personal Information

    FULL NAME : RINKU PRASAD


    MOTHER's NAME : MANJU DEVI
    FATHER's NAME : AMAR NATH
    Date of Birth : 1995-04-03
    Email : [email protected] Gender : M
    Nationality : Indian Category : SC
    Physically Challenged ? :N
    Mobile Number : 9621676243
    Correspondence Address: village post kaneti block gorawal district sohnabhdra,up-231210
    Permanent Address : village post kaneti block gorawal district sohnabhdra,up-231210
    State : Uttar Pradesh

    2. Application Fee Details

    Application Fee : 250


    E-receipt no. : DU65769827
    Date of Payment : 2017-05-05

    3. Programme Selection :
    Student Status : Full-Time Regular
    Financial Status : Institute Assistantship Required

    3A. Select the Primary Programme you are applying for (Compulsory) :
    Programme : M.Tech
    Department/School: Department of Chemical Engineering & Technology
    Discipline: Chemical Engineering
    Spec 1:No Specialization
    Spec 2:No Specialization
    Spec 3:No Specialization
    Spec 4:No Specialization
    Spec 5:No Specialization
    3B. Additional Programme 1 : 3C. Additional Programme 2 :
    Programme : null Programme : null
    Dept/School:null Dept/School: null
    Discipline: null Discipline: null
    Spec 1:null Spec 1:null
    Spec 2:null Spec 2:null
    Spec 3:null Spec 3:null
    Spec 4:null Spec 4:null
    Spec 5:null Spec 5:null

    Spec = Specialization
    4. Qualifying Entrance Examination :

    Category of Examination : Gate/GPAT Qualified


    Name of the Exam : GATE
    Reg./Rollno. CH17S75019292
    Exam discipline : CHEMICAL ENGINEERING
    Exam Year : 2017
    Exam Rank : 1941
    Exam Score : 410
    5. Academic Details :
    5A. Qualifying Degree details : 5B. Other Degree details :
    Degree : UG Degree Degree :
    Degree Status : Appearing Degree Status :
    Degree Name : BTech Degree Name :
    University : HBTU University :
    Discipline : CHEMICAL ENGINEERING
    Discipline :
    Exam Year : 2017 Exam Year :
    % or CGPA : 67 % or CGPA :
    5C. Intermediate (10+2):
    Name of Certificate : INTERMEDIATE
    Name of Board : CBSE
    Subjects : PHYSICS,CHEMISTRY,MATHS,ENGLISH,HINDI
    Year of Passing : 2012
    Final Aggregate % or CGPA: 82.2
    5D. High School (10th):
    Name of Certificate : HIGH SCHOOL
    Name of Board : CBSE
    Subjects : ENGLISH,HINDI,MATHS,SOCIAL SCIENCE,SCIENCE
    Year of Passing : 2010
    Final Aggregate % or CGPA: 8.6

    6. Work Experience(Mandatory if applying under sponsored category):


    First Work Experience : Second Work Experience :
    Period from : Period from :
    Period to : Period to :
    Organization : Organization :
    Position : Position :

    7. Declaration:
    I declare that the information provided by me on this application form is correct to the
    best of my knowledge and belief. I understand that any wilful misinterpretation of facts
    will result in my disqualification and dismissal from the Institute if admitted.

    Candidate signature

    Application no.: 17110680


    Date & Time of Submission: 05:09PM on May 05, 2017

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