Career Planning and Development Division (CPDD)

GCET / GIMT / GU
Student Profile
Paste Your
Enrollment No. Name
Photograph
Father’s Name Mother’s Name
Course (B.Tech./MCA): Branch: _________Batch/Section:
Sex Date of Birth (DD/MM/YYYY)
M F

Admission Through : (UPSEE/AIEEE/Direct) General Rank

Academic Details:
10th %age/CGPA : ………………. 10th Passing year : ………………. 10th Board Name:…………………

10th School’s Name-……………………………………… 10th Passing state :…………………

12th %age : ………………. 12th Passing year : ………………. 12th Board Name:…………………

12th School’s Name-……………………………………… 12th Passing State :…………………

Diploma %age : ………………. Diploma Passing year : …………………………………….

Diploma Course Name-………………………………………………………………………………………

Diploma College/ University Name-…………………………………………………………………………………..

B.Tech
Semester I II III IV V VI VII VIII
B.Tech - Percentage / SGPA

Total No. of History Backlogs (both Total No. of

Dead/Active) Current Backlog
(only
Active/pending)
Total No. of Gap in Academics 10th Details of Gap
onwards (In years)

Category (Gen/SC/ST/OBC)

Student’s Mobile __________ Student’s E-mail

Father’s Qualification Father’s Occupation:

Monthly Income (Father’s-Mobile no)
Mother’s Name Occupation

Resi.No.
Present Address:

City :………………………. State:………………………….. Pin Code:………………….

Permanent Address:

City :………………………. State:………………………….. Pin Code:………………….

Technical Knowledge, if any

Extra Curricular activities

I hereby confirm that the information furnished by me is correct to the best of my

knowledge. I would be liable of disciplinary action, if any of the information provided by
me is found misleading or incorrect.

Signature (Student)