Personal Details:

User ID 22188055

Candidate's Name PRIYANSH GUPTA

Candidate's First Name PRIYANSH

Candidate's Middle Name

Candidate's Last Name GUPTA

Date of Birth 21/Jan/2002

Country India
Email ID priyanshgupta573@gmail.com

Alternate Email ID
Mobile No 91 9026865877

Other Personal Details:

Father's/Guardian's Name VINOD KUMAR GUPTA

Mother's/Guardian's Name SHOBHA GUPTA

Spouse's Name

Candidate Gender Male Category General

Country Indian Other Country

State/Union Territory of Serial/Entry

Category Number of the
Caste
Caste/Tribe Name
Do you belong to Persons No Is the disability
with Disabilities (PwD) measurable?
category as per RPwD Act
2016?
Percentage of Disability PwD UDID
Number

PwD Category

Do you require wheelchair Would you be

support at the test centre? using a scribe for
the Test?
First Covid Vaccination Second Covid
Date Vaccination Date
Communication Address :
Address Line1 147 AZAD GANJ , SIPRI BAZAR , JHANSI

Address Line2
Address Line3
Country India Other Country
State/Union Uttar Pradesh State/Union
Territory Territory
District Jhansi Other District
Town/City Jhansi Pincode 284003

Communication Address :
Emergency 9889695087 Relationship with mother
Mobile Number Candidate
SSC/10th/Equivalent Details :
SSC/10th/Equivalent Board Name Central Board of Secondary Education

Other Board Name

Month/Year of Completion June / 2017

Maximum Marks 500

Total Marks Obtained 456 Aggregate 91.2

Percentage (%)
HSC/12th/Equivalent/Diploma Course Details:
Course Type 12th/Equivalent

University/Board/Other Authority
Name
12th/Equivalent Board Name Central Board of Secondary Education

12th/Equivalent Other Board

Name
Duration of Diploma Course (In
Year)
Discipline Science

12th/Equivalent Other Discipline Month/Year of Course

Commencement /

Month/Year of Completion Aggregate Marks or

May / 2019
Promotion/Pass
without Marks?
Maximum Marks (Inclusive of all Total Marks Obtained 373
subjects) 500 (Inclusive of all
subjects)
Aggregate Percentage (%) 74.6

First Bachelor's Degree Details:

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

Have you completed Bachelor's Degree?

Total Duration of Degree 4 Year Current Semester Semester-7
Type of Private University Other Type of
University/Institution University/Institution
State/Union Territory of Uttar Pradesh Other State/Union Territory
University of University

University/Institute Name Uttar Pradesh Technical Other University/Institute

Name
Name of College/Institution SR GROUP OF Degree Name BTECH
INSTITUTIONS JHANSI

Other Degree Name Discipline Computer Science

Graduation Stream Engineering Does the 'Other Discipline'

closely relate to
'Engineering/Technology'?
Other Discipline Name

Month/Year of Course August / 2019 Probable Month/Year of June / 2023

Commencement Course Completion
Aggregate Marks or Promotion/Pass without Marks? Aggregate Marks

Aggregate Marks (%) 84.73

Do you have or are you undergoing dual or 5 year integrated course? No

I have more than one Bachelor's Degree

Second Bachelor's Degree Details:

Are you in the final year of Bachelor's Degree?
Have you completed Bachelor's Degree?
Total Duration of Degree Current Semester

Type of Other Type of

University/Institution University/Institution
State/Union Territory of Other State/Union Territory
University of University

University/Institute Other University/Institute

Name Name

Name of Degree Name

College/Institution

Other Degree Name Discipline

Graduation Stream Does the 'Other Discipline'

closely relate to
'Engineering/Technology'?
Other Discipline Name Month/Year of Course /
Commencement
Month/Year of Aggregate Marks or
/
Completion Promotion/Pass without
Marks?
Aggregate Marks (%)
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 Type of University/

Institution

Other Type of University/Institution State/Union Territory of

University

Other State/Union Territory University/Institute Name

of University

Other University/ Name of College/

Institute Name Institution

Degree Name Other Degree Name

Discipline Does the 'Other Discipline'

closely relate to
'Engineering/Technology'?
Other Discipline Name Month/Year of /
Commencement
Probable Month/Year of Completion Aggregate Marks or
/
Promotion/Pass without
Marks?
Aggregate Marks (%)
Other Professional Degree Details:
Are you a Fellow of the Institute of Actuaries of India (FIAI) ? No
FIAI Final Aggregate Month/Year of /
Marks (%) Commencement
Month/Year of Do you want to enter any No
Completion / professional degree details
such as CA/CS/ICWA?
Degree Completion Degree Completion Status
Status
Degree Completion Specify Other Professional
Status Degree

Professional Inter Professional Final Marks

Marks (%) (%)
Professional Final Aggregate Marks Month/Year of Course /
(%) Commencement
Month/Year of / Probable Month/Year of /
Completion Completion
Work Experience (If any):
Industry Type Work Experience Work Experience Gap in work Work Experience
Start Date End Date experience (In days as on 31st
July 2022)
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 days as on 31st July 2022)

Programmes:

Programme Name Selected/Not Interview City

IIM Ahmedabad PGP Selected
Delhi

Bengaluru

IIM Ahmedabad PGP- Delhi

Selected
FABM
Bengaluru

IIM Ahmedabad ePGD-ABA Selected Interviews will be organized only

through virtual mode

IIM Ahmedabad PhD Selected Ahmedabad

Delhi
Selected
IIM Amritsar MBA
Bengaluru

Delhi
Selected
IIM Amritsar PhD Bengaluru
 IIM Amritsar EMBA Selected Delhi

Bengaluru

Delhi
IIM Amritsar Selected
MBA-Business Analytics Bengaluru

Delhi
Selected
IIM Amritsar MBA-HRM Bengaluru

Delhi
Selected
IIM Bangalore PGP Bengaluru

IIM Bangalore PGPEM Selected Bengaluru

IIM Bangalore PhD Selected Bengaluru

Delhi
Selected
IIM Bangalore PGPBA Bengaluru

Delhi
Selected
IIM Bodh Gaya PGP
Bengaluru

IIM Bodh Gaya PhD (FPM) Selected Bodh Gaya

Delhi
Selected
IIM Calcutta MBA Bengaluru

IIM Calcutta PhD Selected Kolkata

IIM Indore PGP Selected Delhi

Bengaluru

IIM Indore PGP-HRM Selected Delhi

Bengaluru

IIM Indore MSDSM Selected Indore

IIM Indore FPM Selected Indore

Delhi (NCR)
IIM Jammu MBA Selected
Bengaluru

IIM Jammu PhD Selected Jammu

IIM Kashipur MBA Delhi

Selected
Bengaluru

IIM Kashipur EMBA Kashipur

Selected
Dehradun

IIM Kashipur EMBAA Selected Kashipur

IIM Kashipur PhD Selected Kashipur

Delhi
IIM Kashipur MBA Selected
(Analytics) Bengaluru

IIM Kozhikode PGP Delhi

Selected
Bengaluru

IIM Kozhikode PGP-F Selected Delhi

Bengaluru
IIM Kozhikode PGP-LSM Delhi
Selected
Bengaluru
Delhi
IIM Kozhikode PGP-BL Selected
Bengaluru

IIM Kozhikode EPGP Kochi Selected Kozhikode

Kochi

IIM Kozhikode PhD Selected Kozhikode

IIM Lucknow PGP Delhi (NCR)

Selected
Bengaluru

IIM Lucknow PGP-ABM Selected Delhi (NCR)

Bengaluru

IIM Lucknow PGPWE Selected Delhi (NCR)

IIM Lucknow PGP-SM Selected Delhi (NCR)

Bengaluru

IIM Lucknow PhD Selected Lucknow

IIM Nagpur MBA Selected Delhi

Bengaluru

IIM Nagpur MBA Selected Nagpur

(Executive) Pune
Selected Nagpur
IIM Nagpur PhD
(Executive)
IIM Nagpur PhD Selected Nagpur

IIM Raipur PGP Selected Delhi

Bengaluru

IIM Raipur FPM/PhD Selected Raipur

IIM Raipur EFPM Selected Raipur

IIM Ranchi PGP Selected Delhi

Bengaluru

IIM Ranchi PGP (Business Selected Delhi

Analytics) Bengaluru

IIM Ranchi PGP-HRM Selected Delhi

Bengaluru

IIM Ranchi PhD Selected Ranchi

IIM Ranchi EPhD Selected Ranchi

IIM Rohtak PGP Selected Delhi

Bengaluru

IIM Rohtak EPGDSM Selected Rohtak

IIM Rohtak PhD Selected Rohtak

IIM Sambalpur MBA Delhi

Selected
Bengaluru

IIM Sambalpur Executive Selected Delhi

MBA Bengaluru

IIM Sambalpur PhD Selected Delhi

Bengaluru
 IIM Sambalpur Executive Selected Delhi
PhD
IIM Shillong PGP Delhi
Selected
Bengaluru

IIM Shillong PGPEX Selected Delhi

Bengaluru

Selected Shillong
IIM Shillong MBA (WE)
Guwahati

IIM Shillong PhD Delhi

Selected
Bengaluru

IIM Shillong PhDWP Selected Shillong

Guwahati

IIM Sirmaur MBA Selected Delhi (NCR)

Bengaluru

IIM Sirmaur MBA (T&HM) Selected Delhi

Bengaluru

IIM Sirmaur ExMBA Selected Sirmaur

IIM Sirmaur PhD Selected Delhi

Sirmaur
Delhi
IIM Tiruchirappalli PGPM Selected
Bengaluru

IIM Tiruchirappalli PGPM- Selected Delhi

HR Bengaluru

IIM Tiruchirappalli PGPBM Selected Chennai

IIM Tiruchirappalli DPM Selected

IIM Tiruchirappalli E-DPM Selected

Delhi
IIM Udaipur MBA Selected
Bengaluru

IIM Udaipur MBA-DEM Selected Udaipur

IIM Udaipur MBA-GSCM Selected Udaipur

IIM Udaipur PGDBAWE Selected Udaipur

IIM Udaipur PhD Selected Udaipur

IIM Visakhapatnam PGP Selected Delhi

Bengaluru

IIM Visakhapatnam PhD Selected Visakhapatnam

IIM Visakhapatnam PGPEx Selected Visakhapatnam

IIM Visakhapatnam Selected Visakhapatnam

PGPDGM
Test City Preferences:
Preferred Test State- Uttar Pradesh - Jhansi Preferred Test State- Madhya Pradesh - Gwalior

City 1 City 2
Madhya Pradesh - Bhopal Preferred Test State- Madhya Pradesh - Indore
Preferred Test State-
City 3 City 4
 Uttar Pradesh - Kanpur New Delhi - New Delhi
Preferred Test State- Preferred Test State-
City 5 City 6
Payment Details :
Transaction Number 15847633259 Payment mode: online

Applicable Registration 2300 Payment Status S

Fee (Rs)

Declaration:
I have previewed the Application Form by clicking on the Preview Application Button and confirm
that all the data reflecting in the Preview are correct.

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 2022 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 2022
application & scores. I understand that all disputes will be subject to the territorial jurisdiction of city
of Bangalore only.