Centre for Distance & Online Education

ANNEXURE I - PROJECT GUIDE REGISTRATION FORM

(To be submitted to the Project Steering Committee via LMS upload)
Instruction: Please provide the below details about your Proposed Project Guide:
1. Name of the Proposed Project Guide: Mohammad Fraz
2. Date of Birth: 24/5/1994
3. Present Employer: Learn yard technology
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4. Designation: Co-founder
5. Contact Details:
i) Residential Address: Bengluru ,karnataka ,india
ii) Office Address:Bengluru
iii) All communications are to be sent to Residential/ Official address (tick anyone)
iv) Contact No.: v) E-mail id:
6. Education Qualification (start with the highest qualification):
(Please attach photocopies of degree certificates)
S. No. Name of Specialization Year of Institution/University Class
the Degree Passing Obtained
1 Computer 2021 Delhi Technology First class
Software univercity with
engineering distinction

7. Area of Specialization/Interest: software development

8. Total yrs. of Experience: (Please attach photocopies of Experience letters)
S. Name of the Designation From To duration
No. organization
1 Learn-Yard technology Co-founder Sep 2023 present 5 mos
2 google Software engineer Jun 2022 Sep 2023 1 yr
3 Cure.fit Software engineer Jul2019 Jun2022 1 yr
4 Sap labs india SDE intern May 2019 July 2019 3 mos

I hereby declare that the information provided by me is true. I agree with the
rules and regulations given by the University.
M-Faiz.
Signature (Proposed Guide)
Name - Mohammad Faiz.

(FOR OFFICE USE)

Following details have been verified
Yes No
Sl. No
1 Qualification yes
2 Experience yes
3 PAN Card (in case of Domestic Guide) yes
4 Passport (in case of Foreign Guide) yes
5 Approved for Department / Specialization yes

Signature Signature
(Faculty in-charge) (Project Steering Committee)
(Note: Filled in Registration forms must be scanned in either .pdf / .doc format
and submitted along with credentials (Scanned copy of Degree Certificates, PAN
Card (for Domestic Guide), Passport (for Foreign Guide) and Experience
Certificates of the proposed guide) on LMS portal- link).

Centre for Distance & Online Education 2