Personal Details:

User ID 23040176

Candidate's Name MUDIT SHARMA

Candidate's First Name MUDIT

Candidate's Middle Name

Candidate's Last Name SHARMA

Date of Birth 05/Dec/2004

Country India

Email ID mudits05.ms@gmail.com

Alternate Email ID amritasharma1701@gmail.com

Mobile No 91 6266873084

Other Personal Details:

Father's/Guardian's Name PANKAJ SHARMA

Mother's/Guardian's Name AMRITA SHARMA

Spouse's Name

Candidate Gender Male Category General

Nationality Indian Other Nationality

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 15, Pawan Nagar , Nemawar Road , Palda , Indore

Address Line2
Address Line3
Country India Other Country
State/Union Madhya Pradesh Other State/Union
Territory Territory
District Indore Other District
Town/City Indore Pincode 452001

Emergency Contact Details :

Emergency 9926303039 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 March 2019

Maximum Marks (Inclusive of all subjects): 500

Total Marks Obtained 460 Aggregate 92

(Inclusive of all subjects) 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 Commerce

12th/Equivalent Other Discipline Month/Year of Course

Commencement

Month/Year of Completion April 2021 Aggregate Marks or Aggregate Marks

Promotion/Pass
without Marks?
Maximum Marks (Inclusive of all Total Marks Obtained 450
subjects) 500 (Inclusive of all subjects)

Aggregate Percentage (%) 90

I declare that I have not been awarded

any marks due to Covid-19 and if this
information found to be incorrect,
CAT 2023 holds right to cancel my
application.
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 3 Year Current Semester Semester-4

Type of Central University Other Type of

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

University/Institute Name Devi Ahilya Other University/Institute

Name
Name of College/Institution International Institute Of Degree Name BBA
Professional Studies

Other Degree Name Discipline Management (Business

Administration/Business
Management/Business
Studies/Management Studies)
Graduation Stream Non Engineering

Other Discipline Name

Month/Year of Course November 2021 Probable Month/Year of December 2024

Commencement Course Completion

Aggregate Marks or Promotion/Pass without Marks?
Aggregate Marks (%) 92

I declare that I have not been awarded any marks due to Covid-19 and if this
information found to be incorrect, CAT 2023 holds right to cancel my application.

Do you have or are you undergoing dual or 5 year integrated course? Yes

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 College/ Degree Name

Institution

Other Degree Name Discipline

Other Discipline Name

 Graduation Stream: Month/Year of Course
Commencement
Probable Month/Year Aggregate Marks or
of Completion: Promotion/Pass without
Marks?
Aggregate Marks (%)

I declare that I have not been awarded any marks due to Covid-19 and if this
information found to be incorrect, CAT 2023 holds right to cancel my application.
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 Name of College/

University/ Institution
Institute Name
Degree Name Other Degree Name

Discipline

Other Discipline Name Month/Year of

Commencement
Probable Month/Year of Completion Aggregate Marks or
Promotion/Pass without
Marks?
Aggregate Marks (%)
I declare that I have not been awarded any marks due to Covid-19 and if this information found
to be incorrect, CAT 2023 holds right to cancel my application.
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 2023)
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 2023)

Total Work Experience(In Month and days as on July 31, 2023)
Programmes:
Programme Name Selected/Not Interview City

Not Selected
IIM Ahmedabad PGP

IIM Ahmedabad PGP- Not Selected

FABM
IIM Ahmedabad ePGD-ABA Not Selected

IIM Ahmedabad Doctoral Not Selected

Programme in Management

Not Selected
IIM Amritsar MBA

IIM Amritsar PhD Not Selected

IIM Amritsar Executive Not Selected

MBA

IIM Amritsar Not Selected

MBA-Business Analytics

IIM Amritsar MBA-Human Not Selected

Resource Management

IIM Amritsar M.Sc. In Data

Not Selected
Science(MSDSM) jointly
offered with IIT Ropar

IIM Bangalore PGP Not Selected

IIM Bangalore PGPEM Not Selected

Not Selected
IIM Bangalore PhD

IIM Bangalore PGPBA Not Selected

Not Selected
IIM Bodh Gaya MBA

IIM Bodh Gaya PhD Not Selected

IIM Bodh Gaya MBA (Digital Not Selected

Business Management)

IIM Bodh Gaya MBA (Hospital Not Selected

and Healthcare Management)

Not Selected
IIM Calcutta MBA

IIM Calcutta Doctoral Programme Not Selected

(PhD)
Selected Indore
IIM Indore PGP
Mumbai

IIM Indore PGP-HRM Not Selected

 IIM Indore MSDSM Not Selected

IIM Indore FPM Not Selected

IIM Jammu MBA Not Selected

IIM Jammu PhD Not Selected

IIM Jammu MBA(Hospital

Not Selected
Administration & Healthcare
Management)

IIM Jammu Ph.D(Working Not Selected

Professionals)

Not Selected
IIM Jammu Executive MBA

Not Selected
IIM Kashipur MBA

Not Selected
IIM Kashipur EMBA

IIM Kashipur EMBAA Not Selected

IIM Kashipur PhD Not Selected

IIM Kashipur MBA Not Selected

(Analytics)
Not Selected
IIM Kozhikode PGP

Not Selected
IIM Kozhikode PGP-F

IIM Kozhikode PGP-LSM Not Selected

IIM Kozhikode PGP-BL Not Selected

IIM Kozhikode EPGP Kochi Not Selected

Not Selected
IIM Kozhikode PhD
IIM Kozhikode Fellow
Programmes in Management
Not Selected

PhD (PT)
IIM Kozhikode Executive Post
Graduate Programme in Not Selected
Management through Interactive
Learning (EPGP-IL)
IIM Lucknow MBA Not Selected

IIM Lucknow MBA-ABM Not Selected

IIM Lucknow PGPWE Not Selected

IIM Lucknow MBA-SM

Not Selected
 IIM Lucknow PhD Not Selected

Not Selected
IIM Lucknow MBA-EandI
Not Selected
IIM Nagpur MBA

IIM Nagpur MBA Not Selected

(Executive)
IIM Nagpur PhD Not Selected
(Executive)
IIM Nagpur PhD Not Selected

IIM Raipur PGP Not Selected

IIM Raipur FPM/PhD Not Selected

IIM Raipur EFPM Not Selected

Not Selected
IIM Ranchi MBA

IIM Ranchi MBA Not Selected

(Business Analytics)

IIM Ranchi MBA-HRM Not Selected

IIM Ranchi PhD Not Selected

IIM Ranchi EPhD Not Selected

IIM Rohtak PGP Not Selected

IIM Rohtak PGPX Not Selected

Not Selected
IIM Rohtak EPGDSM
IIM Rohtak PhD Not Selected

IIM Sambalpur MBA Not Selected

IIM Sambalpur Executive Not Selected

MBA
IIM Sambalpur PhD Not Selected

IIM Sambalpur Executive Not Selected

PhD

IIM Sambalpur MBA for Not Selected

Working Professional

Not Selected
IIM Shillong PGP

Not Selected
IIM Shillong PGPEX

IIM Shillong PGP (WE) Not Selected

IIM Shillong Doctoral Program Not Selected

IIM Shillong Doctoral Not Selected

Program (WP)
Not Selected
IIM Sirmaur MBA

IIM SirmaurMBA (Tourism Not Selected

Management)
IIM Sirmaur ExMBA Not Selected

IIM Sirmaur PhD Not Selected

IIM Sirmaur PhD(Executive) Not Selected

IIM Tiruchirappalli PGPM Not Selected

IIM Tiruchirappalli PGPM- Not Selected

HR

IIM Tiruchirappalli PhD

Not Selected

IIM Tiruchirappalli Executive Not Selected

PhD

IIM Udaipur MBA Not Selected

IIM Udaipur MBA-DEM Not Selected

IIM Udaipur MBA-GSCM Not Selected

IIM Udaipur PGDBAWE Not Selected

IIM Udaipur PhD Not Selected

Not Selected
IIM Visakhapatnam PGP

IIM Visakhapatnam PhD Not Selected

IIM Visakhapatnam EMBA Not Selected

IIM Visakhapatnam Not Selected

PGPDGM
Test State-City Preferences:
Madhya Pradesh - Indore Madhya Pradesh - Ujjain
Preferred Test State- Preferred Test State-
City 1 City 2

Preferred Test State-

Maharashtra - Mumbai Preferred Test State- Madhya Pradesh - Bhopal

City 3 City 4

Preferred Test State-

Madhya Pradesh - Gwalior
Preferred Test State- Gujarat - Ahmedabad

City 5 City 6
Payment Details :
Transaction Number ZIC51358729732 Payment Mode online

Applicable Registration 2400 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 2023 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 2023 application & scores. I understand that all disputes will be subject
to the territorial jurisdiction of city of Lucknow only.