NIRMA UNIVERSITY, AHMEDABAD

Application Form
Institute of Technology Admission
BACHELOR OF TECHNOLOGY

Application ID : ITNU2017218 Application Under : B.Tech. (ALL INDIA CATEGORY) - .Outside Gujarat(12th
Passed from outside Gujarat)

Personal Detail

Applicant's Name : SURAJ P Mother's Name : DEEPA P

BHADANIA BHADANIA

Father's Name : PRADEEP B Alternative Email :

BHADANIA SURAJBHADNAIA17@GMAIL.COM
Date of Birth : 17/10/2002 Alternative Mobile : 9448870588
Nationality : INDIAN Gender : Male
Mobile No : 7411006588
Email ID :
surajpateloctober@gmail.com

Correspondence Address

ANJALI APARTMENT BHOJA RAO LANE,KAMBALA CROSS ALAKE MANGALURU KARNATAKA INDIA 575003

Details of Qualification
Qualification Board/ School Name Total Obtained Percentage Year of
University Marks Marks Obtained Passing
SSC Karnataka Secondary CANARA HIGH 625 587 93.92 2018
Education Examination SCHOOL
Borad
HSC Karnataka Board of the EXPERT PU 600 540 90 2020
Pre-University COLLEGE
Education

HSC Subject wise marks

Subject Total Marks Obtained Marks

Mathematics 100 100
Physics 100 94
Chemistry 100 86
Vocational Subject 100 91

Program Preference
Program Preference
Computer Science and Engineering 1
Electronics and Communication Engineering 2
Mechanical Engineering 3
Electrical Engineering 4
Instrumentation and Control Engineering 5
Civil Engineering 6
 Chemical Engineering 7

Entrance Exam JEE (Main)-2020 Examination

Final NTA Score (Paper – I) B.E./B.TECH All India Rank (CRL) Document
94.3084949 images

Payment Details
DD No / Bank Transaction ID Payment Mode Transaction Date Drawn Bank Amount
NA Online 01:44:01 PM 31/08/2020 NA 1416.00

Documents Uploaded
Document Name File Name
JEE (Main) – 2020 Scorecard file-82031598861941.png
HSC (Std.-12th Marksheet) file-98881598862370.jpeg
SSC (Std.-10th Marksheet) file-49171598862648.jpeg
JEE (Main) – 2020 Admit Card (April Examination) file-72891598862705.pdf
School Leaving / Transfer Certificate file-62971598862967.jpeg
JEE (Main) – 2020 Admit Card (January Examination) file-93021598863592.jpeg

I certify that the information given above is correct. I understand that if any information is found incorrect, my
candidature is liable to be cancelled.

Date : Applicant Signature

Place :

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