STUDENT INFORMATION SHEET
2012 Passing out Batch
Paste Passport
1. Name : …………………………………………………………………………… Size Photograph
2. Date of Birth : ……………………………………………………………………………
3. Stream : ……………………………………………………………………………
4. Registration No. : …………………………………………………………………………….
5. Roll No. : …………………………………………………………………………….
6. Marks/Grades Obtained: ……………………………………………………………………………..
Class X Class XII Diploma
Board: Board: Board:
YOP Total Marks % of Marks Actual Marks% YOP Total Marks % of Marks Actual Marks% YOP % of Marks
Obtained Obtained
[Link] Details:
SEM I SEM II SEM III SEM IV SEM V SEM VI SEM VII SEM VIII Average
7. Address for Communication (Present) : ……………………………………………………………….
……………………………………………………………….
……………………………………………………………….
8. Address for Communication (Permanent) : ……………………………………………………………….
……………………………………………………………….
……………………………………………………………….
9. Father’s Name : ……………………………………………………………….
10. Father’s Occupation : ……………………………………………………………….
11. Mother’s Name : ……………………………………………………………….
12. Mother’s Occupation : ……………………………………………………………….
13. Guardian’s Name : ……………………………………………………………….
14. Guardian’s Occupation : ……………………………………………………………….
15. Telephone No. & Mobile No.* : ……………………………………………………………….
……………………………………………………………….
16. Email ID : ……………………………………………………………….
17. Joint Entrance Exam Rank (AIEEE/WBJEE/JELET)*: …………………………………………………….
Signature of candidate
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