Indian Institute of Technology Guwahati

Application Form for Admission to MDes Programme

 APPLICATION NO 201803054200137

 PERSONAL INFORMATION
 Name Prankur Kataria
 Gender MALE
 Father/Guardian's Name R K Kataria
 Date of Birth  1994/07/08
 Marital Status SINGLE
 Nationality Indian
 Caste Category General 
 Physically Disabled (PwD)   NO 
 Student Type Regular 

 ADDRESS INFORMATION
 Correspondence Address 
 Address Line 1 DH-28, Scheme No. 74 C Address Line 2 Vijay Nagar
 Address Line 3 Vill./Town/CityIndore
 State Madhya Pradesh District Indore
 Pin 452010
 Email prankur.k@gmail.com Mobile No. 8982115770

 Permanent Address 
 Address Line 1 B-561 Address Line 2 NFL Township
 Address Line 3 Vill./Town/City Vijaipur
 State Madhya Pradesh District Guna
 Pin 473111
 Email prankur.k@gmail.com Mobile No. 8982115770

 EDUCATIONAL QUALIFICATION
 Details of Board/Universities/Institutions attended (from 10th standard onwards)#
 (Attested copies of certificates and mark sheets/grade cards will require if called for written 
test/Interview/Counseling).
Equivalent
%/Grade
Exam Board/Univ./Inst.Degree Disc. Subjects %/CGPA/CPI Percentage Year Status
out of
(%)
Science,
Central Board of English,
Class 10th or Class 10th or CGPA out
Secondary Sanskrit, 9.8 98 2010 Passed
Equi. Equi. of 10
Education Maths, Social
Sciencce
 English Core,
Mathematics,
Central Board of
Class 12th or Physics, % out of
Secondary Class 12th 87.4 87.4 2012 Passed
Equi. Chemistry, 100
Education
Computer
Science
Rajiv Gandhi Electronics and
First Degree Bachelor of CGPA out
Proudyogiki Communication 7.67 76.7 2016 Passed
or Equi. Engineering of 10
Vishwavidyalaya Engineering

 Qualifying Degree
 * Qualifying degree here means that degree by virtue of which only you become eligible to apply for 
admission to M.Tech./MDes/MS(R) programme of IIT Guwahati.
Equivalent
Qualifying %/Grade
Degree Disc. Board/Univ./Inst. Subjects %/CGPA/CPI Percentage Year Status
Degree out of
(%)
OTHER (Rajiv
Electronics & Gandhi Electronics and CGPA
B.E. 7.67 76.7 2016 Passed
Communication Proudyogiki Communication out of 10
Vishwavidyalaya)

# (a)  Candidates still to appear in their qualifying degree examinations may also apply, provided they 
appear in all their qualifying degree examinations and complete all requirements for their degrees before 
14-07-2018. If selected, such candidates shall be admitted provisionally, and they will have to furnish the 
results of their qualifying degree examinations latest by 21-08-2018, failure to which their admissions shall 
stand automatically cancelled. 
# (b)  If final year qualifying degree examination results are awaited, please indicate average percentage of 
marks or CPI of examinations up to the last year (in case of system with annual examination)/last semester 
(in case of semester system). 

 PROFFESIONAL QUALIYING EXAMS PASSED (GATE/CEED/NET JRF/INSPIRE)
 CEED CEED Roll 
:  2004070
Number
CEED Part B 
:  52.51
Marks 
All India Rank  :  209
Year of 
:  2018
Appearing CEED 

 LIST OF PUBLICATIONS/CONFERENCE PAPERS (IF ANY)
Title Author(s) Journal/Conference Volume Year
Assistive Headlights Prankur Kataria Indian Express 0 2015

 PROFESSIONAL EXPERIENCE (Teaching/ Research/ Industrial) IF ANY
* Proof to be attached if called for written test/Interview/Counseling.
Name Of
Position Held Type Of work Start date End Date
Organization
Associate  Java Front End 
DXC Technology 2016-11-08 2018-03-25
Professional Developer

 DOCUMENTS UPLOADED
Sl No Particulars Upload Status
1. Photo Uploaded
2. Signature Uploaded
3. Qualifying Degree Marksheet Uploaded
4. Qualifying Degree Certificate Uploaded
5. Qualifying Examination Score Card Uploaded

 PROGRAMME
You have applied in MDes in Design
 Your Preferences are as follows
 Priority 1 Design

Declaration
          I hereby declare that the entries made in this application form are correct to the best of my knowledge 
and belief. If selected for admission, I promise to abide by the rules and regulations of the Institute.

          I note that the decision of the Institute is final in regard to selection for admission and assignment to a 
particular Department/Centre and field of study. The Institute shall have the right to take any action it 
deems fit, including expulsion, against me at any time after my admission, if it is found that any 
information furnished by me is incorrect. 

Place : 

Date : 2018-05-08  Signature