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    App 19010400353 PDF

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    vanshika
    The document contains an application form for Vanshika Bansal, an Indian citizen seeking admission to SRM IST in Chennai for a Bachelor of Technology in Computer Science with specializations in Information Technology, Software Engineering, or Big Data Analytics. It includes her personal details, educational qualifications, family information, address, payment details, and declaration. She is currently in 12th grade and scored 78% in 10th board exams.

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    App 19010400353 PDF

    Uploaded by

    vanshika
    54 views2 pages
    The document contains an application form for Vanshika Bansal, an Indian citizen seeking admission to SRM IST in Chennai for a Bachelor of Technology in Computer Science with specializations in Information Technology, Software Engineering, or Big Data Analytics. It includes her personal details, educational qualifications, family information, address, payment details, and declaration. She is currently in 12th grade and scored 78% in 10th board exams.

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    The document contains an application form for Vanshika Bansal, an Indian citizen seeking admission to SRM IST in Chennai for a Bachelor of Technology in Computer Science with specializations in Information Technology, Software Engineering, or Big Data Analytics. It includes her personal details, educational qualifications, family information, address, payment details, and declaration. She is currently in 12th grade and scored 78% in 10th board exams.

    Copyright:

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

    App 19010400353 PDF

    Uploaded by

    vanshika
    The document contains an application form for Vanshika Bansal, an Indian citizen seeking admission to SRM IST in Chennai for a Bachelor of Technology in Computer Science with specializations in Information Technology, Software Engineering, or Big Data Analytics. It includes her personal details, educational qualifications, family information, address, payment details, and declaration. She is currently in 12th grade and scored 78% in 10th board exams.

    Copyright:

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

    APPLICATION

    FORM 2019
    APPLICATION
    NO:19010400353

    Personal Details :
    Name MS VANSHIKA BANSAL
    Mobile No. +91-8218648950
    Nationality INDIAN
    Social Status GENERAL
    Blood Group B+
    Email Address [email protected]
    Date Of Birth 27/11/2000
    Gender FEMALE
    Alternate Email Address [email protected]
    Are you Differently Abled ? NO Nature Of Deformity : Percentage Of Deformity :

    Preference Details
    # Specialization Preference Campus Preference Test City Preference
    B TECH - CSE W/S IN INFORMATION
    1 SRM IST, MAIN CAMPUS (KATTANKULATHUR, CHENNAI) AGRA
    TECHNOLOGY
    2 B TECH - CSE W/S SOFTWARE ENGINEERING SRM IST, MAIN CAMPUS (KATTANKULATHUR, CHENNAI) ALIGARH
    3 B TECH - CSE W/S BIG DATA ANALYTICS SRM IST, NCR CAMPUS, DELHI NEW DELHI

    Address Details:
    Address A-6/262 KAMLA NAGAR AGRA Pin Code : 282005
    Country Name : INDIA State : UTTAR PRADESH District : AGRA Town/City: AGRA

    Family Details:
    Father Mother
    Name NEERAJ BANSAL NAINA BANSAL
    Mobile Number +91-9412509626 +91-8279808462
    Email Address [email protected]

    Educational Details:
    SSC Details (10th) HSC Details (12th) : 12TH APPEARING
    Institute Name ST. PATRICKS JUNIOR COLLEGE AGRA MILTON PUBLIC SCHOOL AGRA
    COUNCIL OF INDIAN SCHOOL CERTIFICATE
    Board CENTRAL BOARD OF SECONDARY EDUCATION (CBSE)
    EXAMINATION (CISCE/ICSE)
    Scheme PERCENTAGE
    Percentage / CGPA 78
    Year Of Passing 2017
    Registration No. 6457627

    Payment Details
    Transaction ID 108542140561
    Payment Date 25/03/2019
    Mode Of Payment Net Banking

    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.

    VANSHIKA BANSAL

    25/03/2019

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