APPLICATION

FORM 2019
APPLICATION
NO:19010437362

Personal Details :
Name MR RATNA KISHORE TADINADA
Mobile No. **************
Nationality INDIAN
Social Status GENERAL
Blood Group AB+
Email Address ***************@GMAIL.COM
Date Of Birth 19/10/1998
Gender MALE
Alternate Email Address
Nature Of Deformity : SPEECH AND
Are you Differently Abled ? YES Percentage Of Deformity : 40 %
HEARING DISABILITY

Preference Details
# Specialization Preference Campus Preference Test City Preference
B TECH - ECE W/S IN INSTRUMENTATION
1 SRM IST, MAIN CAMPUS (KATTANKULATHUR, CHENNAI) GHAZIABAD
ENIGNEERING
B TECH - ECE W/S IN INSTRUMENTATION
2 SRM UNIVERSITY, AP, AMARAVATI
ENIGNEERING
3

Address Details:
Address 14-40-1/2 BANK COLONY Pin Code : 534101
Country Name : INDIA State : ANDHRA PRADESH District : WEST GODAVARI Town/City: TADEPALLIGUDEM

Family Details:
Father Mother
Name T K V PRASAD T V V SAVITHRI
Mobile Number
Email Address

Educational Details:
SSC Details (10th) HSC Details (12th) : 12TH COMPLETED
Institute Name DELHI PUBLIC SCHOOL AGRA S R M JUNIOR COLLEGE HYDERABAD
Board CENTRAL BOARD OF SECONDARY EDUCATION (CBSE) TELANGANA BOARD OF INTERMEDIATE EDUCATION
Scheme CGPA OUT OF 10 PERCENTAGE
Percentage / CGPA 6.8 65.3
Year Of Passing 2014 2017
Registration No. 5106927 1761315007

Payment Details
Transaction ID 929109918524
Payment Date 24/04/2019
Mode Of Payment DD
Declaration
I certify that the information submitted by me in support of this application is true to the best of my knowledge and belief. I understand that
in the event of any information being found false or incorrect, my admission is liable to be rejected/ cancelled at any stage of the program. I
undertake to abide by the disciplinary rules and regulations of the institute.

RATNA KISHORE TADINADA

24/04/2019