APPLICATION FORM 2023-24

School: School of Engineering

Course: B.Tech - Computer Science & Engineering
Application Form Number: DSU/ONL/23/712566

PERSONAL DETAILS

Full Name: Parshid B K

Email: parshidkumar666@gmail.com
Mobile: 919353669302

Date of Birth: 25-Aug-2003 Gender: Male

Nationality: Indian Aadhar Card Number: 236857864973

Blood Group: O+ Religion: HINDUISM

Caste Category: General Physically Challenged: No

Do you need Hostel Accomodation: No Do you need Transportation?: No

Mother Tongue: Nepali

PROGRAM OPTED FOR ADMISSION

Admission Mode: DSAT Mode of Exam: Home Based Proctored Examination

Branch Prefernce 2: B.Tech - Computer Science & Engineering

Branch Prefernce 1: B.Tech - Computer Science & Engineering
(AI&ML)

I, hereby, declare that, I am aware of the fact that, from the

next academic year 2023-24, the DSU Campus will shift to a
130-acres sprawling green campus in Harohalli, Kanakapura
Branch Prefernce 3: B.Tech - Computer Science & Engineering
Road, equipped with all the modern state-of-the-art-
(Data Sciences)
infrastructure, facilities and creating a conducive environment
for a progressive experiential learning and futuristic growth.

: True

ABOUT DSU
How did you get to know about DSU?: Through Reference

PARENT'S DETAILS

FATHER'S DETAILS
Father's Name: Padam Bahadur B K Father's Mobile Number: 917411351154

Father's Annual Income: 200000

MOTHER'S DETAILS
Mother's Name: Shivdevi B K Mother's Mobile Number: 918105366451

GUARDIAN'S DETAILS
Guardian's Name: Dharmaraj B K Guardian / Emergency Mobile Number: 918861684080
ADDRESS DETAILS

POSTAL ADDRESS DETAILS

Address Line 1: 24 main road 8 cross, 1 sector hsr layout
Country: India
agara

State: Karnataka District: Bengaluru Urban

City: Bangalore [Bangalore] Pincode: 560102

PERMANENT ADDRESS DETAILS

Address Line 1: 24 main road 8 cross, 1 sector hsr layout
Country: India
agara

State: Karnataka District: Bengaluru Urban

Pincode: 560102

EDUCATIONAL DETAILS

10TH STANDARD / O LEVEL / EQUIVALENT ACADEMIC DETAILS

Year of Passing: 2021 Board: State Board

Institute Name: Shubhodhini English High School State: Karnataka

City: Bangalore [Bangalore] Marks Scheme: Percentage

Percentage: 64.16

PUC/XII/EQUIVALENT ACADEMIC DETAILS

What is the status of your result?: Declared Year of Passing: 2023

Board: State Board Institute Name: Bangalore pu college

State: Karnataka City: Bangalore urban

Stream: Science Your 12th Marks Sheet: DSU_ONL_23_712566_c84965.jpg

Marks Scheme: Percentage Percentage: 56.3

DOCUMENTS
Your 10th Marks Sheet: DSU_ONL_23_712566_07e693.jpg

PAYMENT DETAILS

Applying For: B.Tech - Computer Science & Engineering

Transaction Id: b757e6b7-0df5-464e-9c5b-2ff767188c62 Payment Mode: UPI

Payment Date: 16-Jun-2023 02:42 PM Course Amount: 1000.00 (₹)

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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 DSU.

Parshid B K

Applicant Name:

Parent Name:

Date:

Place: