You are on page 1of 2

Walkin 2010 - Screening Form

Token No. _________________


(To be issued at the time of the selection process)
Request you to fill the following details:

Name
Date of Birth
Year of Passing
BE/B.Tech/MCA
College Name
Name of the University
Mobile Number
Email ID

Educational Qualifications (Aggregate of all semesters)


Education % Marks Education % Marks
10th (%) Graduation (%)
BE/B. Tech.

12th & Diploma (%) MCA

No. of Backlogs/Reattempts/ATKT

Semester 12345678
No. of
Backlogs

Certifications:

I declare that the above information is true to the best of my knowledge.

Signature: ______________

Confidential | Copyright © Larsen & Toubro Infotech Ltd.

You might also like