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    SRM Application Form

    Uploaded by

    rishabh
    This document contains an application form submitted by Rishabh Bhardwaj for admission to the B.Tech program at SRM Institute of Science and Technology. The applicant's preferences are the Computer Science and Engineering program with a specialization in Cloud Computing at the Main Campus in Kattankulathur, Chennai. Personal details provided include the applicant's name, date of birth, gender, address, academic qualifications including 12th grade results, and payment details. Both the applicant and his father Radha Raman Sharma electronically signed the declaration on December 19th, 2022.

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    SRM Application Form

    Uploaded by

    rishabh
    57 views3 pages
    This document contains an application form submitted by Rishabh Bhardwaj for admission to the B.Tech program at SRM Institute of Science and Technology. The applicant's preferences are the Computer Science and Engineering program with a specialization in Cloud Computing at the Main Campus in Kattankulathur, Chennai. Personal details provided include the applicant's name, date of birth, gender, address, academic qualifications including 12th grade results, and payment details. Both the applicant and his father Radha Raman Sharma electronically signed the declaration on December 19th, 2022.

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    Srm Application Form

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    This document contains an application form submitted by Rishabh Bhardwaj for admission to the B.Tech program at SRM Institute of Science and Technology. The applicant's preferences are the Computer Science and Engineering program with a specialization in Cloud Computing at the Main Campus in Kattankulathur, Chennai. Personal details provided include the applicant's name, date of birth, gender, address, academic qualifications including 12th grade results, and payment details. Both the applicant and his father Radha Raman Sharma electronically signed the declaration on December 19th, 2022.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    57 views3 pages

    SRM Application Form

    Uploaded by

    rishabh
    This document contains an application form submitted by Rishabh Bhardwaj for admission to the B.Tech program at SRM Institute of Science and Technology. The applicant's preferences are the Computer Science and Engineering program with a specialization in Cloud Computing at the Main Campus in Kattankulathur, Chennai. Personal details provided include the applicant's name, date of birth, gender, address, academic qualifications including 12th grade results, and payment details. Both the applicant and his father Radha Raman Sharma electronically signed the declaration on December 19th, 2022.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    B.

    TECH APPLICATION FORM 2023 (PHASE-1)


    APPLICATION NO : 23011004536

    Program And Campus Preference


    Campus SRMIST, Main Campus Program Computer Science Specialization
    Cloud Computing
    Preference 1 (Kattankulathur, Chennai) Preference 1 And Engineering Preference 1
    Campus SRMIST, Ramapuram Program Computer Science Specialization
    Cloud Computing
    Preference 2 Campus Preference 2 And Engineering Preference 2
    Artificial
    Campus SRMIST, Vadapalani Program Computer Science Specialization
    Intelligence And
    Preference 3 Campus Preference 3 And Engineering Preference 3
    Machine Learning

    Personal Details
    Nationality Indian
    Have You Studied From India? Yes
    Student Aadhar No. 266604389174
    Category
    Full Name (As Per The Qualifying Examination Certificate) Rishabh Bhardwaj
    Mobile No. +91-7838832025
    WhatsApp Mobile Number +91-7838832025
    Email ID [email protected]
    Alternate Email ID [email protected]
    Date Of Birth 22/09/2005
    Gender Male

    Family Details
    Parent Details : Father
    Father Mother Guardian
    Title Mr
    Name Radha Raman Sharma
    Mobile Number +91-9810032025
    Email Address [email protected]

    Address Details
    Address A-215 Aali Vihar Pin Code : 110076
    Country Name : India State : Delhi District : South Delhi City: South Delhi

    Academic Details
    Current Education Qualification Status : 12th Appearing
    XII Details : X Details :
    Institute Name DAV PUBLIC SCHOOL DAV PUBLIC SCHOOL
    Board Central Board Of Secondary Education (CBSE) Central Board Of Secondary Education (CBSE)
    Mode of Study Regular Regular
    Marking Scheme Percentage
    Percentage / CGPA 82
    Year Of Passing 2021
    Hall ticket No./Registration No. D121252250227
    Address Of School/College Dav public school, jasola vihar -
    NAD ID/Digilocker ID -
    Marks In Qualifying Exam (HSC) In Tamil Nadu/CBSE/Other Boards
    Subjects/Group:
    Maximum Marks Obtained Marks Percentage
    English
    Language - II
    Language - III
    Maths
    Physics
    Chemistry
    Biology
    Computer Science
    Botany
    Zoology
    Other :

    PCM/PMB/PCB/PMO Average
    Total Maximum Marks Total Obtained Marks Total Percentage
    Marks

    Marks In Qualifying Exam In Andhra Pradesh/Telengana State 12th (I And II)


    Subjects/group :
    Maximum Marks Obtained Marks Percentage
    English - I
    English - II
    Language (II) 1
    Language (II) 2
    Language (III) 1
    Language (III) 2
    Mathematics Paper-1 (A)
    Mathematics Paper-1 (B)
    Mathematics Paper-2 (A)
    Mathematics Paper-2 (B)
    Physics paper 1
    Physics paper 2
    Physics paper practical
    Chemistry Paper I
    Chemistry Paper II
    Chemistry Practical
    Botany paper I
    Botany paper II
    Botany Practical
    Zoology paper I
    Zoology paper II
    Zoology Practical
    Other :

    PCM/PCB/PMO/PMB Average Total Maximum Marks Total Obtained Marks Total Percentage

    Payment Details
    Transaction ID 111742695827
    Payment Date 19/12/2022
    Mode Of Payment
    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 The Institute.

    Applicant Name : Rishabh Bhardwaj

    Parent Name : Radha Raman Sharma

    Date : 19/12/2022

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