Personal Interview Form

MASTER OF BUSINESS ADMINISTRATION : ADMISSION-2019

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Fill this form through Adobe Acrobat DC version (download : http://www.adobe.com/go/reader) only & submit the same

Nirma ID. : 96617 CAT Reg No 8136755

Interview Date 07/03/2019 Interview Centre 03-Delhi

Interview Time 1 pm Mobile 8952826486

__________________

AMAN JAIN
Name (Block Letters):_____________________________________________________________________________________
(As per your last marksheet)

E-mail : AMANJAIN.AJ097@GMAIL.COM
_____________________________________________________________________ Applicant’s
Photograph
(to be affixed
HINDU
Religion : _______________ Open
Category: Do you belong to religious minority : No on
printout
form
Gender : Male Date of Birth: 08-05-1997
__________________________ (not required
in Softcopy)
YOGESH JAIN
Father’s Name :_______________________________________________________________________

A. EDUCATION Note : For the purpose of calculating Total Maximum Marks, Marks Obtainedand Aggregate Percentage of
Marks, please include marks of ALL SUBJECTS i.e. compulsory as well as optional (if any) for SSC, HSC & Graduation.

Total Maximum Obtained Aggregate Year of First Attempt

Particular Board Name Marks/CGPA
Marks / CGPA Percentage of Marks Passing (Y/N)
S.S.C CBSE 10 10 100 2013 Yes

H.S.C. CBSE 500 447 89.4 2015 Yes

Name of the Graduation Degree B.Tech Mode : Full Time

Stream Engineering Specialization if any COMPUTER SCIENCE

College Name JECRC

University Name RAJASTHAN TECHNICAL UNIVERSITY
Graduation Status Pursuing Year of Admission : 2015
Marks Obtained Total Aggregate
Year Maximum
Obtained Percentage Year of
(Mention only upto pre-final 1stSem/Term 2ndSem/Term 3rdSem/Term
Marks Marks of Marks Passing
years Marks only) (a) (c) (a+b+c) (a+b+c)
(b) (a+b+c)

First Year* 824 799 1623 2000 81.15 2016

Second Year* 754 820 1574 2000 78.7 2017

Third Year* 719 731 1450 2000 72.5 2018

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MENTION GRADUATION PRE-FINAL MARKS (Calculate all subjects marks (compulsory and optional) upto prefinal year

Total Marks Obtained Maximum Aggregate

Total Marks Maximum
(consider up to pre-final exam) CGPA/CPI CGPA/CPI percentage
Obtained Total Marks (if applicable) (if applicable) of Marks
For Example – BA\BCom\BSc
should mention the marks for
first year and second year only. 4647 6000 77.45
Similarly B.E.\B.Tech should
mention the marks for first,
second and third year only Note : In case the university awards CGPA \ CPI instead of percentage of marks the
candidate is required to provide the conversion formula for converting CGPA \ CPI in to
percentage of marks and mention the computed percentage in column no. 5. Also
please attach the Grade Conversion formula

Have you passed all examinations in single attempt? Yes

B. Any other Qualifications:

Name of the Exam Passed Duration Year of Passing Name of the Aggregate Marks
University/Institute Obtained (%)

C. WORK EXPERIENCE* (Only full-time job after graduation in a professional organization) as on 31.01.2019
Sr. Period (in months)
Organisation Position P.F. No
No. From To Total Months

1.

2.

3.

Total Number of Months

* Please submit relevant documents.
a) experience certificate indicating date of joining, date of relieving, designation held, salary and P.F.No.
b) Salary slip indicating salary detail showing PF deduction and professional tax deduction.
c) In the absence of experience certificate, submit a copy of the offer letter along with the first salary slip and
last salary slip bearing P.F. No.

D. COORDINATOR OF SOCIAL GROUP OF COLLEGE -SOCH

EXTRA-CURRICULAR ACTIVITIES (IF ANY):______________________________________________________
3 YEARS STALL EXPERIENCE AT RENISSANCE (ANNUAL TECHNO CULTURAL FEST)
_______________________________________________________________________________________________
PARTICIPATED IN JECRC HACKATHON 2018
_______________________________________________________________________________________________
PARTICIPATED IN SWACHTA PAKHWADA BY AICTE 2017
_______________________________________________________________________________________________

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 E. ACHIEVEMENTS (IF ANY):______________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

Note : List of Documents (self-attested photo copies except Data Sheet) to be submitted to the interview panel in the sequence
as mentioned below

Sr No. Particular Checklist (Yes/No)

1. Personal Interview Form Yes No

2. CAT Score cards Yes No

3. S.S.C Marksheet Yes No

4. H.S.C Marksheet Yes No

5. Graduation Marksheet Yes No

First Year Marksheet Sem-I Yes/No Sem-II Yes/No

Second Year Marksheet Sem-III Yes/No Sem-IV Yes/No

Third Year Marksheet Sem-V Yes/No Sem-VI Yes/No

6. Proof for Grade conversion formula in case the same is not indicated in Yes No
the Grade report (If applicable)

7. Proof of Special Achievement - participated co-curricular, extra Yes No

curricular activities, and accomplishments

8. Work experience certificate Yes No

9. Salary Slip (First \ Last) Yes No

10. Copy of the ID proof (aadhar card /driving license/election ID/ ID Yes No
card issued by the college/organization)

Declaration:
I hereby declare that the information given by me in the form is true to the best of my knowledge and belief, and I am
aware that providing incorrect information may result in cancellation of the admission secured, any time during the
entire period of my study at the Institute of Management, Nirma University.

✔ I Agree

JAIPUR
Place: ___________________
06-03-2019
Date : ___________________ Signature of the Applicant