XAT APPLICATION FORM

2021

APPLICATION NO:
XAT21070440

Personal Details
Name Mr. Rishabh Mishra
Email Address rishabh.170.misra@gmail.com Alternate Email Address ri.170.sh@gmail.com
Mobile Number +91-8887513384 Alternate Mobile Number +91-9415035854
Date of Birth 11/09/1999 Gender Male
Nationality Indian Marital Status Married
Blood Group AB+ Category General
Proof of Identity Aadhar Card Aadhaar Card Number 835723238157
Pan Card Voter ID
Driving License Country Of Residence
Do You Belong To Person
No Are You Visually Challenged?
With Disability?
Would You Be Using A Scribe Percentage Of Visually
For The Test? Challenged Disability

Passport Details
Passport Number Country Place Of Issue Date Of Issue Date Of Expiry

Family Details
Father's/Husband's Mother's
Name Rajneesh Kumar Mishra Kiran Mishra
Mobile Number +91-9453835454 +91-9335242989
Email Address rajneesh.rajpur@gmail.com
Occupation Government Sector Home Maker
Designation Teacher
Organisation Aminabad Inter College
City Currently Working In LUCKNOW
Annual Income RS. 600001-700000

Address Details
Communication
Country India
State / Province Uttar Pradesh
District Lucknow
City Lucknow
Address Line 1 House no. 170 Shekhupura colony
Address Line 2 Aliganj, Lucknow
Pin Code: 226022

Xth Details
Institute Year of Marking Maximum Marks Obtained
Board State City
Name Passing Scheme Marks Obtained Percentage/CGPA
Council Of Indian
St. Antony School Certificate Uttar
LUCKNOW 2015 Percentage 600 491 81.83
Inter College Examination Pradesh
(CISCE/ICSE)
XIIth Details
Institute Year of Marking Maximum Marks Obtained
Board Stream State City
Name Passing Scheme Marks Obtained Percentage/CGPA
Council Of
St. Antony Indian School
Uttar
Inter Certificate Science LUCKNOW 2017 Percentage 500 323 64.60
Pradesh
College Examination
(CISCE/ISC)

Diploma Details
Institute Year of Marking Maximum Marks Obtained
Board Stream
Name Passing Scheme Marks Obtained Percentage/CGPA

CA Details
Degree Completion Professional Inter Professional Final Month/Year Of Course Month/Year Of
Status Marks (%) Marks (%) Commencement Completion

CFA Details
Degree Completion Professional Inter Professional Final Month/Year Of Course Month/Year Of
Status Marks (%) Marks (%) Commencement Completion

ICWA Details
Degree Completion Professional Inter Professional Final Month/Year Of Course Month/Year Of
Status Marks (%) Marks (%) Commencement Completion

CS Details
Degree Completion Professional Inter Professional Final Month/Year Of Course Month/Year Of
Status Marks (%) Marks (%) Commencement Completion

Graduation Details
Dr. A.P.J. Abdul
Kalam Technical
Status Appearing State Uttar Pradesh Board/University
University, Uttar
Pradesh
Other (BABU
BANARASI DAS
College University/College Type State University Exam Pattern Semester Wise
ENGINEERING
COLLEGE)
Current Semster/
7 Degree B.Tech Stream Computer Science
Year
Year of Passing 2021 Marking Scheme Percentage Maximum Marks
Obtained Marks Obtained Percentage/CGPA 75.82

Post Graduation Details

Status State Board/University
College University/College Type Exam Pattern
Current Semster/ Year Degree Stream
Year of Passing Marking Scheme Maximum Marks
Obtained Marks Obtained Percentage/CGPA

Work Experience
Do you have any Work Experience? :
Name of the Employer Designation From To Total work Exp(in months)
1.
2.
3.
4.
5.
Total Work Experience (In Months) :

Program Details
Do You Want To Apply For XLRI? : No
Programme :
What Will Be Your First Preference Between HRM And BM? :
Select First City Preference : Lucknow Select Second City Preference : Kanpur

Documents Details

Signature

Xth Certificate YES

XIIth Certificate YES
Diploma Certificate NO
Graduation Certificate NO
Post Graduation Certificate NO
Work Experience Certificate NO

Declaration
I hereby certify that the information given by me in this Application Form is true to the best of my knowledge. I certify that I fulfill the 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 application and scores.The XAT online date mentioned on the website is subject to change.
Applicant Name : Rishabh Mishra Date : 30/11/2020