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Application Form 303228

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ADMISSION APPLICATION FORM

2023-2025
APPLICATION NO. : 303228

Program Details
No. Of Courses You Want To Apply For? One Program
Program Preference 1 PGDM
Program Preference 2
Program Preference 3
Program Preference 4
Your preferred mode of interview
Centre If In-Person Interview Mumbai

Do You Want To Apply Through Do You Want To Apply Through


No No
CAT 2022 XAT 2023
Do You Want To Apply Through Do You Want To Apply Through
No Yes
GMAT CMAT 2023
Fill Your CAT USER
Fill Your CAT 2022 Email-ID
ID/Registration Number
Fill Your XAT-2023 ID Fill Your GMAT ID
Are you a
Fill Your CMAT-2023 Application
MBBS/CA/CS/CWA/Topper of No
Number
ELITE college?

Personal Details :
First Name Vedant Middle Name
Last Name Pandya Full Name Vedant Pandya
Registered Email [email protected] Registered Mobile Number +91-8758905552
Alternate Mobile Number +91-8107961950 Date Of Birth 21/12/2000
Gender Male Category General
Are You Of Goan Domicile Origin ? No

Address Details :
Is permanent address same as address for communication? No
Correspondence Permanent
Address Line 1 House No. 1301, 13th Floor, D-Block, Aryan Gloria Flat Vedant Medical Store, Near Bus Stand, Dhambola
Address Line 2 Gala Gymkhana Road, South Bopal, Bopal, Ahmedabad Dhambola
City Name Ahmedabad Dungarpur
District Name Ahmedabad Dungarpur
State Name Gujarat Rajasthan
Country Name India India
Pincode 380058 314402

Educational Details
Class X Class XII Diploma
Institute/School Name Indian Public School, Simalwara Central Public School, Udaipur
Rajasthan Board Of Secondary Central Board Of Secondary
Board
Education Education (CBSE)
Specialization - Science
Year of Passing 2015 2017
Marking Scheme Percentage Percentage
Obtained Percentage / CGPA 87 58
Graduation Details
Graduation
Graduation Completed Completed
Stream Of Graduation Engineer
Branch Of Engineering Graduation Computer Sc./IT
Graduation State Gujarat
Graduation Board / University Parul University, Gujarat
Graduation College Parul University, Gujarat
Mode Of Graduation Regular

Graduation Academic Details :


Name of Month and Year of Month And Year of Marking Obtained CGPA /
Branch of Graduation
Degree Commencement Completion Scheme Percentage
Computer Science and
B.Tech 08/2017 04/2021 CGPA 7.00
Engineering

Other Qualification? :

Professional Qualification Details :


Name of Qualification
Name of Institute
Qualification Status
Level Achieved

Post Graduation Details :


Degree Name
University Name
Completion date
Would You Like To Get More Information About Our Fellowship (FPM) Programme?

Work Experience
Do You Have Full-Time Work Experience After Graduation? Yes
1. 2. 3. 4. 5.
Organization Name Techforce Global
Associate Software
Designation
Engineer
Start Date 01/12/2021
End Date 26/06/2022
Duration (In Months) 7
Last Annual
3
Salary(in Lakhs)
Total Work Ex (In
7
Months).

Achievers Round
Do You Wish To Provide Details Of Your Achievement? No
Achievement 1
Achievement 1 : Represented Your
Please Give Details Of The Achievement 1
Achievement 2
Achievement 2 : Represented Your
Please Give Details Of The Achievement 2
Achievement 3
Achievement 3 : Represented Your
Please Give Details Of The Achievement 3
Father's Details :
Father's Name Mr Mehul Pandya
Education Qualification M.A(Hindi), B.Ed Occupation Government Sector
Name Of Company Or
1st Grade Teacher Mobile Number +91-9672158024
Organisation

Mother's Details :
Mother's Name Mrs Shilpa Pandya
Educational Qualification Bachelor of Commerce Occupation Homemaker
Name Of Company/ Organisation Mobile Number +91-8107961950

Guardian's Details :
Guardian's Name
Educational Qualification Occupation
Name Of Company/ Organisation Mobile Number

Upload documents :

Upload Your Photograph

Upload Document For Goan Domicile NO

Declaration :
I hereby declare that the particulars given in this application form are true and correct, and they will be supported by original documents
when asked for. I am also fully aware that in the event of any information being found incorrect or misleading, my candidature shall be liable
to cancellation by the Institution at any time. Any dispute concerning Admissions to GIM would be subject to Jurisdiction of the competent
Courts within the territorial jurisdiction of Panaji only.
I agree to receive SMS from GIM, Goa on my registered mobile number.
I understand that my CAT details will not be considered for the admission process if the application fee amount is paid after 20th December
2022.

Applicant Name Vedant Pandya Parent Name Mehul Pandya Date 18/11/2022

Signature

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