Personal Details

User ID 9127271
SIDDHARTHA GUPTA
Candidate's Name

Date of Birth 04/Dec/1996

Country India

Email ID siddharthagupta20@gmail.com

Mobile Number 7839468692

Other Personal Details

Father's/Husband's/Guardian's YOGENDRA NATH
Name
NEETA GUPTA
Mother Name

Category: General State/Union Territory of Caste/Tribe:

Serial/Entry Number of Caste/Tribe: Gender: Male

Nationality: Indian Other Nationality:

Caste/Tribe Name: Aadhaar Card Number: 209908074826

Do you belong to Persons with Disabilities (PwD) category as per RPwD Act 2016: No

PwD Category:

Do you require wheelchair support at the test centre?: Would you be using a scribe for the Test?:

Communication Address
997/6
Address Line1

Address Line2 Jankipuram Extension

Address Line3

Country: India Pincode: 226031

State: Uttar Pradesh Email id: siddharthagupta20@gmail.com

District: Lucknow Mobile Number: 7839468692

Town/City: lucknow Alternate Email id:

Emergency Contact Details

Emergency Mobile Number: 9451038692 Relationship with Candidate: Father

SSC/10th/Equivalent Details

SSC/10th/Equivalent Board Council for Indian School Certificate Examination

Name

Month/Year of Completion: May 2013

Total Marks Obtained 548

(Inclusive of all subjects):
Maximum Marks 600
(Inclusive of all subjects):

Aggregate Percentage (%) : 91.33

HSC/12th/Equivalent/Diploma Course Details

Course Type HSC

HSC Board Name Indian Council of Secondary Education

HSC Other Board Name

Month/Year of Completion: May 2015

Total Marks Obtained

557
(Inclusive of all subjects):

Duration of Diploma Course (In Year): HSC Discipline: Science

HSC Other Discipline

Month/Year of Course Commencement:

Maximum Marks (Inclusive of all subjects): 600

Aggregate Percentage (%): 92.83

Bachelor's Degree Details

Are you in the final year of Bachelor's Degree?: Yes

Have you completed Bachelor's Degree?:

Current Semester: Semester-7

NITs
Type of University/Institution

Total Duration of Degree: 4 Year

Aggregate Marks (%): 72

Jammu and Kashmir
State/Union Territory of
University
 National Institute of Technology, Srinagar
University/Institute Name

national institute of technology srinagar

Name of College/Institution

Degree Name BTECH

Engineering/Technology
Discipline

Month/Year of Course
Commencement July 2016

Probablw Month/Year OR
Month/Year of Completion June 2020

Does the 'Other Discipline' closely relate to 'Engineering/Technology'?:

Second Bachelor's Degree Details

Are you in the final year of Bachelor's Degree?:

:
Have you Completed Bachelor's Degree:?

Current Semester

Total Duration of Degree:

Aggregate Marks (%):

Type of University/Institution

State/Union Territory of

University/Institute Name

Name of College/Institution

Degree Name
 Discipline

Does the 'Other Discipline' closely relate to 'Engineering/Technology'?:

Month/Year of Course Commencement:

Probable Month/Year OR Month/Year of Completion:

Master's Degree Details

Do you want to enter Master's Degree details? No

Master's Degree Completion Status: Total Duration of Degree:

Current Semester: Aggregate Marks (%):

Type of University/Institution

State/Union Territory of
University

University/Institute Name

Name of College/Institution

Degree Name

Discipline

Month/Year of Course
Commencement:

Probable Month/Year OR
Month/Year of Completion

Does the 'Other Discipline' closely relate to 'Engineering/Technology'?:

Other Professional Degree Details

Have you completed any professional degree such as CA/CS/ICWA?: No

Degree Degree Completion Status

CA

ICWA

CS

Name Of Professional Degree

Professional Inter Marks (%): Professional Final Marks (%):

Month/Year of Course Commencement: Month/Year of Completion:

Work Experience
Industry Type Start Date End Date Break in Experiance Work Experience

Automobiles/Auto-ancillaries

Banking/Financial Services

Durables

Engineering/Industrial

Fast Moving Consumer Goods

(FMCG)
Information Technology

Pharmaceuticals/Healthcare

Retail

Telecommunications

Others

Total Work Experience (In months as on July 31 2018):

Programmes

Programme Names Interview City Selected/Not

Selected
IIM Ahmedabad PGP Delhi

IIM Ahmedabad PGP Mumbai Selected

IIM Ahmedabad PGP-FABM Delhi Selected

IIM Ahmedabad PGP-FABM Mumbai Selected

IIM Ahmedabad ePGP Delhi Selected

IIM Ahmedabad ePGP Mumbai Selected

IIM Ahmedabad PhD Ahmedabad Selected

IIM Amritsar PGP Amritsar Selected

IIM Amritsar PGP Amritsar Selected

IIM Bangalore PGP Delhi Selected

IIM Bangalore PGP Mumbai Selected

IIM Bangalore FPM Bangalore Selected

IIM Bangalore PGPEM Delhi Selected

IIM Bangalore PGPPM Delhi Selected

IIM Bangalore PGPPM Bangalore Selected

IIM Bangalore PGPBA Delhi Selected

IIM Bangalore PGPBA Mumbai Selected

IIM Bodh Gaya PGP Delhi Selected

IIM Bodh Gaya PGP Patna Selected

IIM Bodh Gaya PhD (FPM) Bodh Gaya Selected

IIM Calcutta MBA Delhi Selected

IIM Calcutta MBA Mumbai Selected

IIM Calcutta Doctoral Kolkata Selected

IIM Indore PGP Delhi Selected

IIM Indore PGP Indore Selected

IIM Indore PGP-HRM Delhi Selected

IIM Indore PGP-HRM Indore Selected

IIM Indore FPM Indore Selected

IIM Jammu PGP Delhi (NCR) Selected

IIM Jammu PGP Selected

Mumbai
IIM Jammu PhD
Jammu Selected

IIM Kashipur EPGP Kashipur Selected

IIM Kashipur EPGP
Dehradun Selected

IIM Kashipur FPM

Kashipur Selected

IIM Kashipur EFPM Selected

Kashipur

IIM Kashipur PGP Delhi Selected

IIM Kashipur PGP Mumbai Selected

IIM Kozhikode PGP Selected

Delhi

IIM Kozhikode PGP

Mumbai Selected

IIM Kozhikode EPGP IL Delhi Selected

IIM Kozhikode EPGP IL Pune Selected

IIM Kozhikode EPGP Kochi Campus Kochi Selected

IIM Kozhikode EPGP Kochi Campus Thiruvananthapuram Selected

IIM Kozhikode FPM Kozhikode Selected

IIM Lucknow PGP Lucknow Selected

Delhi (NCR) Selected

IIM Lucknow PGP

IIM Lucknow PGP-ABM Lucknow

Selected

IIM Lucknow PGP-ABM Delhi (NCR) Selected

IM Lucknow PGP-SM Lucknow Selected

IIM Lucknow PGP-SM Delhi (NCR) Selected

IIM Nagpur PGP Delhi Selected

IIM Nagpur PGP Mumbai Selected

IIM Raipur PGP Delhi Selected

IIM Raipur PGP Mumbai Selected

IIM Raipur FPM Raipur Selected

Raipur Selected
IIIM Raipur EFPM

IIM Ranchi PGP Delhi Selected

IIM Ranchi PGP Mumbai Selected

IIM Ranchi PGP-HRM Delhi Selected

IIM Ranchi PGP-HRM Mumbai Selected

IIM Ranchi PhD Ranchi Selected

IIM Ranchi EPhD Ranchi Selected

Selected
IIM Rohtak PGP Delhi

Mumbai Selected
IIM Rohtak PGP
IIM Rohtak EPGP Delhi Selected

IIM Rohtak EPGP Chandigarh Selected

IIM Rohtak EPGPX Rohtak Selected

IIM Rohtak FPM Rohtak Selected

IIM Sambalpur MBA Delhi Selected

IIM Sambalpur MBA Mumbai Selected

IIM Sambalpur PhD Delhi Selected

IIM Sambalpur PhD Mumbai Selected

RGIIM Shillong PGP Delhi Selected

RGIIM Shillong PGP Mumbai Selected

RGIIM Shillong PGPEX Delhi Selected

RGIIM Shillong PGPEX Bangalore Selected

RGIIM Shillong FPM Shillong Selected

IIM Sirmaur MBA Delhi (NCR) Selected

IIM Sirmaur MBA Mumbai Selected

IIM Sirmaur PhD Delhi Selected

IIM Sirmaur PhD Sirmaur Selected

IIM Tiruchirappalli PGPM Delhi Selected

IIM Tiruchirappalli PGPM Mumbai Selected

IIM Tiruchirappalli PGPBM Chennai Selected

IIM Tiruchirappalli FPM Trichy Selected

IIM Tiruchirappalli PGP-HR Delhi Selected

IIM Tiruchirappalli PGP-HR Mumbai Selected

IIM Udaipur MBA Delhi Selected

IIM Udaipur MBA Mumbai Selected

IIM Udaipur PhD Udaipur Selected

 IIM Visakhapatnam PGP Delhi Selected

IIM Visakhapatnam PGP Mumbai Selected

IIM Visakhapatnam PGPEX Visakhapatnam Selected

IIM Visakhapatnam PhD Visakhapatnam Selected

Payment Details
Preferred Test City 1:
Lucknow Preferred Test City 2: Delhi

Preferred Test City 3: Kanpur Preferred Test City 4: Varanasi

Payment Details
Payment Mode: online Amount: 1900

Payment Status: S Payment Transaction Number: 9050502871

Order ID: 912727120190914153039

Declaration
I hereby certify that the information given by me in this Application Form is true to the best my
knowledge. I certify that I fulfill the CAT 2019 eligibility criteria and undertake to produce original documents whenever necessary
and I will not demand any reschedule of exam. I agree to abide by the declaration of the authorities regarding the eligibility of my
application and understand that any misrepresentation or omission of facts in my application may justify cancellation of my CAT 2019
application & scores. I understand that all disputes will be subject to the territorial jurisdiction of city of Kozhikode only.