M.Tech.

(Closing Date 19 Apr 2012)

INDIAN INSTITUTE OF TECHNOLOGY DELHI

Application Form for Admission to M.Tech. Programme
Please read the instructions given in the Information Brochure Before you fill up the form Visit : http://www.iitd.ac.in/ Application Number: Admission Type: Category: Test GATE Year 2012 00010080 Full-Time General Registration ID 3153003 Academic Program: Mode of Support: Physically Challenged: M.Tech.(Master of Technology)

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Yes Score 566 Percent 98.5

Discipline Comp Science and Engg/Tech

PROGRAM
Department/Centre: Computer Science & Engineering Program Code: MCS

PERSONAL
Name: PRADEEP JAIN Father Name: PRAKASH JAIN Date of Birth: 03-FEB-1989 Mother Name: GUNMALA JAIN Gender: Male

QUALIFYING DEGREE
Qualifying Exam: B.E. Year of Passing: 2012 Course duration(Years): 4 Discipline: COMP Name of University/Institute: DAVV,I.E.T. Indore Year/Sem Year1/Sem2 Year2/Sem2 Year3/Sem2 Marks Obtained 855 910 936 Max Marks 1200 1200 1200

Year/Sem Marks Obtained Max Marks Year1/Sem1 897 1200 Year2/Sem1 903 1200 Year3/Sem1 896 1200 Year4/Sem1 781 1050 Aggregrate % marks (of all years/semesters): 74.80

PREVIOUS ACADEMIC RECORD

Exam/ Degree 10+2 Discipline MATHS Institute/ University ST. PAUL /CBSE Year of Grading %Marks/ Rank Passing Scheme CGPA 2008 Percent 65 NA

CONTACT DETAILS
Correspondence Address: 284 CH SCHEME 74 C, VIJAY NAGAR, INDORE, Madhya Pradesh, India PIN: 452010 Email: poojacs35@gmail.com 284 CH SCHEME 74 C, VIJAY NAGAR, INDORE, Madhya Pradesh, India PIN: 452010 Email: poojacs35@gmail.com

Mobile No.: 91~9826719058

Permanent Address:

Mobile No.: 91~9826719058

Payment Information
Bank Draft Number: Drawn on: State Bank of india Have you ever studied and discontinued your studies at IIT Delhi ? Date: 28-MAR-2012 Amount Rs: 75.00 No

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FOR DEPARTMENT/CENTRE`S USE

FOR P.G. SECTION USE ONLY

(Recommendations/observations of the office) The candidate may be provisionally admitted/not admitted subject to the following : 1) Submission of attested copies of the qualifying degree certificate and marks sheet showing the required % of marks/CGPA by /. 2) Submission of proof from the University/Head of the Institution of having appeared/passed in the qualifying Degree Examination by . 3) Submission of GATE Score Card (in original) by . 4) Submission of relieving certificate from Employer by .
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