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    Application No. 2019822044: Application Form For Integrated M.Tech. Programmes (2019 - 20)

    Uploaded by

    Yashwanth Reddy
    This document is an application form for an integrated M.Tech program submitted by Oburi Naga Sai Kumar. It provides his personal details like name, date of birth, gender, religion, nationality, contact information, parents name, qualifying exam details, program and campus preferences. It also includes his declaration that the information provided is true and he agrees to abide by the program rules. At the bottom is an acknowledgment of payment of the application fee.

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    Application No. 2019822044: Application Form For Integrated M.Tech. Programmes (2019 - 20)

    Uploaded by

    Yashwanth Reddy
    37 views1 page
    This document is an application form for an integrated M.Tech program submitted by Oburi Naga Sai Kumar. It provides his personal details like name, date of birth, gender, religion, nationality, contact information, parents name, qualifying exam details, program and campus preferences. It also includes his declaration that the information provided is true and he agrees to abide by the program rules. At the bottom is an acknowledgment of payment of the application fee.

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    Original Title

    VIT Application

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    This document is an application form for an integrated M.Tech program submitted by Oburi Naga Sai Kumar. It provides his personal details like name, date of birth, gender, religion, nationality, contact information, parents name, qualifying exam details, program and campus preferences. It also includes his declaration that the information provided is true and he agrees to abide by the program rules. At the bottom is an acknowledgment of payment of the application fee.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    37 views1 page

    Application No. 2019822044: Application Form For Integrated M.Tech. Programmes (2019 - 20)

    Uploaded by

    Yashwanth Reddy
    This document is an application form for an integrated M.Tech program submitted by Oburi Naga Sai Kumar. It provides his personal details like name, date of birth, gender, religion, nationality, contact information, parents name, qualifying exam details, program and campus preferences. It also includes his declaration that the information provided is true and he agrees to abide by the program rules. At the bottom is an acknowledgment of payment of the application fee.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Application form for Integrated M.Tech.

    Programmes
    ( 2019 - 20 )

    Application No.

    2019822044
    Candidate Name : OBURI NAGA SAI KUMAR
    Date of Birth 10-06-2002 Gender MALE
    Religion Hinduism Nationality Indian
    Blood group O+ Mother Tongue Telugu
    Community General/OC Native state Andhra Pradesh
    Mobile No. 9491337715 Email ID. [email protected]
    Parent name Oburi Adhi Narayana Hostel required Yes
    Mode of study Regular Medium of Instruction English
    Qualifying Exam 12th Class Month & Year passing Mar - 2019
    Exam Roll no. 1905236092 Choice of Campus Chennai
    Maximum Marks 10.0 Obtained Marks 9.00
    PCM Marks Physics : 20 Chemistry : 15 Mathematics : 18
    Name of the Board ANDHRA PRADESH BOARD OF INTERMEDIATE EDUCATION
    Permanent Address Door No :3-135/ Oburi vari street, Velpur, Near Savalyapuram, Guntur, Andhra Pradesh-522646
    Address of the school Gudavalli, Vijayawada, Krishna, Andhra Pradesh-521104
    DECLARATION
    I solemnly and sincerely affirm that I am Indian National / PIO/OCI Holder and that all particulars furnished by me in this application form are true and correct.
    I have not concealed any information.However, in the event of any information being found to be incorrect, fraudulent or untrue, either before or after the
    examination or after my admission to the programme, i understand that I am liable to face criminal prosecution and the management can claim all authority to
    cancel my candidature / selection or admission as the case may be and I would have to forgo my seat and the fees.I will pay the required Tuition fees and the
    Hostel fees within the stipulated time to ensure my admission in Vellore Institute of Technology (VIT). I agree to abide by the rules and regulations governing
    the conduct examination as well as the rules pertaining to the refund of Tuition and Hostel fees as per VIT norms & status. I further undertake to submit all the
    required certificates as per the rule, either at the time of counseling or admission process, failing which I understand that I would have to forego my seat and the
    fees. I accept the method for Merit List preparation by VIT. I understand that all information related to VIT application form will be sent through the valid
    mobile number/registered email. I am also aware of the refund policy that the counseling processing fee of Rs.6,000/- is non-refundable.

    Signature of the candidate

    Payment Acknowledgment Copy

    Name of the service provider Techprocess Payment Gateway

    Payment Option Made Netbanking/Credit/Debit Card

    Application No. 2019822044

    Candidate name OBURI NAGA SAI KUMAR

    Transaction No. 803430711

    Application Fee Rs. 850.00

    Transaction Date & Time 18-05-2019 11:59:21

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