Profile of Mentee

Full Name :

Fathers Name : Photo

Mothers Name:

Group :

Medium :

Adm./H.T. No. : Date of .Birth: dd/mm/yyyy

Type of Scholar: a) Day Scholar (Travelling from a distance of_____ KMs) b) Hostler:

Caste :

Religion :

Nationality :

Address : H. No. Street:

Village: Mandal:

Dist: PIN:

State:

Mobile No. :

Aadhaar No. :

Email ID :

WhatsApp No. :

Socio-Economic Background of the Family

Family Profession: Family Annual Income: Rs.

Family Members Name & Qualifications: Father: Mother:

Brother(s): Sister(s):

Parents Mobile No.: Father: Mother:

Mentee (Student) Educational Background

Sl.No. Qualification Institution and Place of Study Year of Pass % Division

1 SSC

2 Inter ( )
 Participation in Extra-Curricular Activities & Sports at College

NSS :

NCC :

Sports :

Certificate Courses Joined at College: 1 2. 3.

Online Certificate Courses Joined: 1. 2. 3.

Future Goal :

Are you doing any Part Time Job: Yes/No

If Yes details of the Part Time Job:

Mentee Attendance
No. of
Year/ June July Aug Sept Oct Nov Dec Jan Feb March April May Days
Sem. ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) Attended %
( )

Mentee Progression Report

Universit
Year Sem. UT-I UT-I Term-I UT-III Term-II Pre-Final y
Exam

Mentor Remarks about Mentee:

Remedies Suggested/Undertaken:
Mentee Sign. Parent Sign. Mentor Sing. Principal Sign.