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    Application Form 24011024187

    Uploaded by

    XCrush

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Application Form 24011024187

    Uploaded by

    XCrush
    4 views2 pages

    Original Title

    Application_form_24011024187

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    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
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    4 views2 pages

    Application Form 24011024187

    Uploaded by

    XCrush

    Copyright:

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

    B.

    TECH APPLICATION FORM 2024 (PHASE-1)


    APPLICATION NO : 24011024187

    Program And Campus Preference


    SRMIST, MAIN CAMPUS
    Campus Program ARTIFICIAL Specialization ARTIFICIAL
    (KATTANKULATHUR,
    Preference 1 Preference 1 INTELLIGENCE Preference 1 INTELLIGENCE
    CHENNAI)
    SRMIST, MAIN CAMPUS
    Campus Program COMPUTER SCIENCE Specialization COMPUTER SCIENCE
    (KATTANKULATHUR,
    Preference 2 Preference 2 AND ENGINEERING Preference 2 AND ENGINEERING
    CHENNAI)
    SRMIST, MAIN CAMPUS ARTIFICIAL
    Campus Program COMPUTER SCIENCE Specialization
    (KATTANKULATHUR, INTELLIGENCE AND
    Preference 3 Preference 3 AND ENGINEERING Preference 3
    CHENNAI) MACHINE LEARNING

    Personal Details
    Nationality INDIAN
    Category (NRI / PIO / OCI)
    OCI/PIO/NRI Number
    Have You Studied From India? YES
    Student Aadhar No. 556818066267
    Full Name (As Per The Qualifying Examination Certificate) DINESH R
    Mobile No. +91-6382957995
    WhatsApp Mobile Number +91-6382957995
    Email ID [email protected]
    Alternate Email ID [email protected]
    Date Of Birth 18/12/2006
    Gender MALE

    Family Details
    Parent Details : FATHER
    Father Mother Guardian
    Title MR
    Name RAGUNATHAN
    Mobile Number +91-6382455364
    [email protected]
    Email Address
    M

    Address Details
    Address 4 - SEMBARUTHI STREET Pin Code : 602001
    Country Name : INDIA State : TAMIL NADU District : TIRUVALLUR City: TIRUVALLUR

    Academic Details
    Current Education Qualification Status : 12TH APPEARING
    XII Details : X Details :
    Institute Name SRI R M JAIN VIDHYASHRAM SRI R M JAIN VIDHYASHARAM
    Board CENTRAL BOARD OF SECONDARY EDUCATION (CBSE) CENTRAL BOARD OF SECONDARY EDUCATION (CBSE)
    Mode of Study REGULAR REGULAR
    Marking Scheme PERCENTAGE
    Percentage / CGPA 77.6
    Year Of Passing 2024 2022
    Hall ticket No./Registration No. 20200216
    Address Of School/College VM NAGAR , THIRUVALLUR -
    NAD ID/Digilocker ID -
    Payment Details
    Transaction ID 113231306165
    Payment Date 30/03/2024
    Mode Of Payment

    Declaration
    I certify that the information submitted by me in support of this application, Is true to the best of my knowledge and belief. I understand that
    in the event of any information being found false or incorrect, My admission is liable to be rejected / cancelled at any stage of the program. I
    undertake to abide by the disciplinary rules and regulations of the institute.

    I hereby declare that I have gone through the eligibility criteria as given in the link below. I am fully aware that, If I do not meet the eligibility
    criteria, any provisional admission given to me during the counselling period will be forfeited.
    For more information , check - https://www.srmist.edu.in/admission-india/engineering

    Applicant Name : DINESH R


    Parent Name : RAGUNATHAN
    Date : 30/03/2024

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