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2/5/2014 IIMR | Admission Form Print

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Indian Institute of Management Ranchi
PGDHRM 2014-16
CAT Registration Number SR9255205
PERSONAL DATA FORM
Name PALLAV SINGH
Date of Birth 03-07-1989
Address for correspondence
D-3,Prem Niketan ApartmentRai ji ki GaliEast Boring
Canal Road,Patna,Bihar,India
Pin 800001
Email ID happypallav@gmail.com
Phone 91 --8879708924
Mobile 91 --9867400275
Nationality Indian
Category General
Phy. Handicapped FALSE
Gender MALE
ACADEMIC QUALIFICATIONS
Pre-Bachelor’s Degree Examination (s)
A. Fill only if a Board or a University Examination.
B. Take into account only the marks in the subjects/papers which are counted for awarding class/division.
Standard Board/University Year Max Marks
Marks
Obtained
Class/
Division
% of Marks
Obtained
10
th
CBSE 2005 600 499 FIRST 83.17
12
th
CBSE 2007 500 396 FIRST 79.20
EDUCATIONAL BACKGROUND
Degree ENGINEERING
Degree Sought B.E.
Subject/Specialization ELECTRONICS AND COMMUNICATION
College/Institute SIR MVIT
University VISVESVARYA TECHNICAL UNIVERSITY
Year From Date To Date Max. Marks/GPA Marks/GPA Obtained % of Marks Obtained
1
st
Year
2008-09-
08
2009-08-01 1550 1359 87.68
2
nd
Year
2009-08-
02
2010-08-01 1800 1472 81.78
3
rd
Year
2010-08-
02
2011-08-01 1800 1259 69.94
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4
th
Year
2011-08-
02
2012-08-01 1650 1310 79.39
Overall percentage of marks obtained 79.41
Class / Division Obtained FIRST
If you are appearing for the final year Bachelor’s Degree examination, indicate the time of examination
If you have already completed the Bachelor’s Degree Examination, indicate month/year of completion
Master’s Degree / Post-Graduation / Professional Qualification
(College/University/Institute attended)
Year From Date
To
Date
Subject
Max.
Marks
Marks
Obtained
% of Marks
Obtained
1
st
Year
2
nd
Year
3
rd
Year
Overall percentage of marks obtained
WORK EXPERIENCE
(Do not include training, project work, work done as an integral part of curricular requirement, and part time work.)
Organization Designation From Year To Year Monthly Remuneration (Rs.) Reasons for leaving
TATA
CONSULTANCY
SERVICES
ASSISTANT
SYSTEM
ENGINEER
2012-09-
24
2014-
01-31
25000
Nature of Responsibility Other
Total work experience
12 (in months) as on 31
st
Aug 2013
* Please bring the total experience certificates and the copies of the all salary slips at the time of interview.
EXTRA-CURRICULAR ACTIVITIES
Please mention inter-collegiate, Institute and higher level activities only. These may include games and sports, cultural, literary and
similar other activities.
National/International State/District Intra-School/Intra College
Olympiad
Scholarship
Others
2/5/2014 IIMR | Admission Form Print
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NTSE Scholar
Please furnish the details of
Extra-Curricular Activities

CO-CURRICULAR ACHIEVEMENTS
Please mention inter-collegiate, Institute and higher level activities only. These may include games and sports, cultural, literary and
similar other activities.

National/
State
District/ University/ Inter-
College
Intra-School/ Intra
College
Intra-Class/
Department
Class Leader/ Council
Leader/ Other Position of
Responsibility
Achievements in Co-
Curricular Activities
Please furnish the details of
Co-Curricular Achievements
Interview City Mumbai
DECLARATION
I have carefully read the instructions and agree to abide by the decision of the institute’s authorities regarding my selection for the
programme.I certify that the particulars given by me in this form are true to the best of my knowledge and belief.

Place
Date Signature