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Admission 2014 - Online Admission Form

Application Number: 168385

Name of the C andidate: Date of Birth: Gender: GD & PI C entre C ode:

GITANJALI SINGH 2/3/1992 F KOLKATA

First C hoice: Third C hoice:

IMT Ghaziabad

Second C hoice: Fourth C hoice:

IMT Hyderabad

C AT 2013 Registration Number: GMAT ID: XAT 2013 ID: C MAT Roll Number: C MAT Test Name:

SR9250087

XAT353292

House Number: Street: C ity: State: PIN C ode: Native State to Which Applicant belongs: Personal E-Mail (which you access on daily basis): Landline Phone no with STD code: Mobile No:

URVASHI SAREES PVT LTD, SITAL SADAN 33 TOLLYGUNJ CIRCULAR ROAD KOLKATA WEST BENGAL 700053 UTTAR PRADESH aquarian.gitanjali@gmail.com 033-24001747 8697287394

CLASS X Board: Name of School: Year of Passing: Percentage of Marks Obtained (##.#) CLASS XII Board: Name of School: Year of Passing: Percentage of Marks Obtained (##.#)
sis.imtcdl.ac.in/ia/PrintFormOnline.aspx?formno=168385

ICSE/ISC St Teresa's Secondary School 2007 89.60

ICSE/ISC St Teresa's Secondary School 2009 92.40

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Admission 2014 - Online Admission Form

GRADUATE DEGREE Type of Graduation: Stream: Actual / Expected Year of Passing: Percentage of Marks (##.#) Name of C ollege: Name of Univeristy: Mode of Study: POST-GRADUATE DEGREE Actual / Expected Year of Passing Percentage of Marks Obtained (##.#) Name of C ollege: Name of University: Stream: 4 Years ENGG/TECH 2013 90.80 KIIT UNIVERSITY KIIT UNIVERSITY FULL TIME

Work Experience:

No

Father's Name: Mother's Name: Parent's Mobile:

DEVENDRA BAHADUR SINGH Sulakshna Singh 9830056401

Amount (Rs.)

1775

sis.imtcdl.ac.in/ia/PrintFormOnline.aspx?formno=168385

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