MEERUT INSTITUTE OF TECHNOLOGY

Department of……………………..
MENTOR RECORD FORM

MENTOR NAME: DESIGNATION:

STUDENT'S PERSONAL DETAILS

NAME:
PASTE
BRANCH: RECENT
PASSPORT SIZE
MOBILE: PHOTOGRAPH

EMAIL-ID:
PARENT'S PERSONAL DETAILS

FATHER'S NAME: PROFESSION:

MOBILE: EMAIL-ID:

MOTHER'S NAME: PROFESSION:

MOBILE: EMAIL-ID:
ADDRESS DETAILS

PERMANENT ADDRESS:

CITY: PIN: STATE:

STUDENT: HOSTEL / DAY SCHOLAR

HOSTEL DETAIL I YEAR II YEAR III YEAR IV YEAR

ROOM NO:

DAY SCHOLAR'S LOCAL ADDRESS:

ACADEMIC BACKGROUND

YEAR OF PASSING SCHOOL NAME BOARD PERCENTAGE

10th

12th

MODE OF ADMISSION: UPSEE COUNSELLING / FEE WAIVER / DIRECT/CCB

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 END SEMESTER EXAM PERFORMANCE

STATUS CARRY OVER COMMUNICATION

SEM % RESPONSE FROM PARENTS
(PASS /CO) SUBJECTS TO PARENTS
I

II

III

IV

VI

VII

VIII

TOTAL PERCENTAGE/CGPA: PASSED IN YEAR:

PARTICIPATION IN EXTRA / CO-CURRICULAR ACTIVITIES

ONLINE COURSE & CERTIFICATION EARNED

INDUSTRIAL TRAININGS / WORKSHOPS

ACHIEVEMENT DETAILS

ANY SPECIFIC PROBLEM OF STUDENT

PROBLEM GIVEN SOLUTION

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