XAT APPLICATION FORM

2022

APPLICATION NO:
XAT22068936

Personal Details
Name Mr. Shub ham Khandelwal Country Of Residence
Email Address khandelwalcycles786@gmail.com Alternate Email Address khandelwalrammohan2@gmail.com
Mobile Number +91-7568272624 Alternate Mobile Number +91-9649796441
Date of Birth 02/11/2001 Gender Male
Nationality Indian Marital Status Single
Blood Group O+ Category General
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

Do You Belong To Kashmiri

Do You Belong To A Kashmiri No
Non-Migrant Family?
Migrant Family?
Passport Number

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

Family Details
Father's Mother's Parent Detail
Name Mr. Ram Mohan Khandelwal
Mobile Number +91-9649796441
Email Address khandelwalrammohan2@gmail.com
Occupation Private Sector
Designation busnissmen
Organisation Busnissmen
Annual Income RS. 200001 - 300000

Address Details
Communication
Country India
State / Province Rajasthan
District Jaipur
City Jaipur
Address Line 1 Birhi Scheme Ward.no.10 Amer
Address Line 2 Near Police Station.Amer
Pin Code: 302028

Xth Details
Year of Marking Maximum Marks Obtained
Institute Name Board State City
Passing Scheme Marks Obtained Percentage/CGPA
Shri Rajasthan
Maheshwari Board Of
Rajasthan JAIPUR 2017 Percentage 600 458 76.33
Senior Secondry Secondary
School Education
XIIth Details
Institute Year of Marking Maximum Marks Obtained
Board Stream State City
Name Passing Scheme Marks Obtained Percentage/CGPA
Shri
Rajasthan
Maheshwari
Board Of
Senior Commerce Rajasthan JAIPUR 2019 Percentage 500 360 72.00
Secondary
Secondry
Education
School

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 Final Marks Month/Year Of Course Month/Year Of
Level
Status (%) 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 I Details
Rajasthan University Of
Status Awaited State Rajasthan Board/University Health Sciences,
Rajasthan
Other (SS Jain
College University/College Type Private University Exam Pattern Year Wise
Subodh College)
Degree B.Com Stream Commerce
Year of Passing 2022 Marking Scheme Percentage Maximum Marks 500
Obtained Marks 420 Obtained Percentage/CGPA 84.00

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

Post Graduation Details

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

Work Experience
Do you have any Work Experience? : No
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? : Yes
Programme : Business Management (BM); Human Resource Management (HRM)
What Will Be Your First Preference Between HRM And BM? : Business Management (BM)
Select First City Preference : Jaipur Select Second City Preference : Delhi-NCR

Documents Details

Signature

Proof of Identity Aadhar Card Aadhaar Card Number 612588757130

Pan Card Voter ID
Driving License Passport Number

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 : Shubham Khandelwal Date : 09/12/2021