Admissions 2017-18: Master of Design (M.Des.

Application Form No.: 500379

PERSONAL DETAILS
Name of Applicant
Adithyan G

Registered Email ID
adithyan29992@gmail.com

Name of Father (of Applicant)

Gowthaman k

Registered Mobile Number

+91 9600897001

Name of Mother (of Applicant)

Ganga Devi G

Alternate Contact Number

+91 9600897001

Place of Birth
coimbatore

Date of Birth
29-Sep-1992

Exam Center
Thiruvananthapuram

CATEGORY DETAILS
Nationality/Citizenship
Indian

Applying in Category
General

DISCIPLINE(S) APPLIED FOR

Product Design

Transportation & Automobile Design

PRESENT ADDRESS

PERMANENT ADDRESS

111,Dr.Rajarathinam street
Kattoor
COIMBATORE-641009
Tamil Nadu-India

111,Dr.Rajarathinam street
Kattoor
COIMBATORE-641009
Tamil Nadu-India

EDUCATIONAL QUALIFICATIONS
10+2 OR EQUIVALENT
Board
stateboard

Stream
computer science,
physics

School
Ramnagar Suburban Matric
Higher Secondary School

Status
Passed

Year
2010

Marking Scheme
Percentage

%/Grade/GPA
88.67

Name of Degree
B.E.Mechanical

College / Institute
SNS College of Technology

Status
Passed

Year
2014

Marking Scheme
GPA

%/Grade/GPA
7.96

Company

Designation

Start Date

End Date

Currently Working Here

QAutomation

Team Member

04-Aug-2014

Till Date

YES

GRADUATION
University
Anna University

EXPERIANCE

PAYMENT DETAILS
Payment Mode
Debit/Credit Card

Ref. Number
667195

Amount in INR
4000

Payment Date
9-Nov-2016

I certify that I have read and understood the information given in National Institute of Design
Admissions Handbook 2017-18. I certify that the information provided in this online application
form is accurate and complete to the best of my knowledge. I declare that I have read and
understood the conditions of eligibility for the programme / discipline for which I seek admission.
In the event of any information provided by me found incorrect, or misleading, or incomplete, my
application shall be liable to cancellation by the Institute at any time and I shall not be entitled to
any refund of the fee paid by me to the Institute.

Applicant Signature
Printed on: 9-Nov-2016


You are NOT required to send printed application when application fee is paid online through credit/debit card.
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