STUDENT DATA SHEET
To be filled in by the Center Counselor (Please note that field marked * are compulsory. Any such field left empty or semi-filled shall not be processed.)
Student Name*: Contact Number:
Devender Kumar Self Mobile* Parent Mobile* Landline +919530206420 +919351689723 +911506222033
Postal Address:
Gurudyal Colony, New Gharsana Ward no. 1 , Dist - Sri Ganganagar Rajasthan 335711
Date of Birth*: Email:
02/12/1990 Email 1*:dev.snob@gmail.com Email 2:dev4u_1990@yahoo.in
Academic Standings*:
If applying for UG admission
XII
If applying for PG admission
UG %
Up to which Semester
66 Desired Program* (Select all that apply): Under Graduate MS MBA MIS Other (Please Specify) Application Term Sought*: (Mention the year) Financial Limitations: Fall (August September) Spring (January February) Any Other Intake M.Tech fall
6th
Country Preference*: University Preference: Work Experience*: Passport held: Tests Record*:
U.K./Canada 1st University Pref. 2nd University Pref. No No If does not plans to give and not preparing If plans to give and not preparing If plans to give and preparing but no sample/mock tests given Test Given/Intended Date Score (if not given, then projected score via sample/mock tests ) GRE GMAT TOEFL IELTS SAT
Commitments made other than contract*: (If any, then please mention the name of approving service counselor) Comments of Center Counselor*:
___________________________________ Name of the Center Counselor
___________________ Date