INDIAN INSTITUTE OF TECHNOLOGY, KANPUR

Application Form For Admissions To Post Graduate 2013-2014

Date:26-MAR-2013 IITK/2013-14-I/PG/2928 26-MAR-2013 Submitted

Reference No: Application Date: Application Status:

1. General Information
Full Name
PRADEEP KUNDU HISAR HARPAL SINGH 26 SHIV NAGAR, GALI NO.1, MILL GATE, c/o KUNDU TUTORIALS HISAR

DOB Sex
Male

14-SEP-1991 Single Indian

Place of Birth Father's Name Address for Corres.

Marital Status Nationality

State E-Mail
pkundu.pradeep@gmail.com

Haryana

PinCode
9818986186

125001

Phone

NA

Mobile

2. Demand Draft Details

DD No.
165197

Amount Rs.
STATE BANK OF INDIA

400.0

DD Date

25-MAR-2013

Issued by Bank Name

Branch Code(Drawee)

00652

3. Student Category and Course Details

Department Financial Status
Mechanical Engg. Institute Asst Req.

Admission for Degree Category

MTech General

Student Status Phy. Handicapped

Full Time No

Areas of specialization in the Department/Programme Pref. 1. Fluid Mechanics and Thermal Sciences Pref. 3. Solid Mechanics and Design Pref. 2. Manufacturing Science Pref. 4.

4. Academic Record/Work Experience

A. GATE,ICMR-JRF,ICAR,DBT-JRF,CEED,CSIR-JRF/LS,UGC-JRF/LS,Other Fellowship Details Exam Name
GATE

Exam Discipline
Mechanical Engg.

Score
535.0

Rank
2295

Exam Year
2013

B. Qualifying Degree already obtained or in Progress University Name

MAHARSHI DAYANAND UNIVERSITY

Uni Address 1
ROHTAK

Uni Address 2

Rank in University
68

Total Student in Uni

NA

Institute Code
HR013

Institute Name
BRCM College of Engg. and Tech. Vill. Behal, Bhiwani

Place

Rank in Institute
10

Degree
B.Tech.

Discipline
Mechanical Engineering

Year of Completed Gradution

2012

Min. Pass Marks

40.0

Max. Marks
100.0

% Marks or Grade Average

Sem. I
73.23

Sem. II
76.43

Sem. III
69.73

Sem. IV
63.3

Overall/Current grade average

72.26

Sem. V
68.45

Sem. VI
67.36

Sem. VII
81.68

Sem. VIII
79.9

C. Other Degrees Obtained after 10+2(Do not include the degree listed in 4B) Degree Discipline University Name & Address Institute Name & Address Marks or Completio CPI n Year

D. Working Experiences Duration Employer Position Nature of work

E. Number of Technical Papers(Provide details separately) Papers Published in Journals

0

Presented in Conference

5. Names and addresses of two referees from whom letters of reference have been obtaioned(For Ph.D Only)
1. Address: Email: 2. Address: Email:

Declaration by the Applicant

Certified that all information provided by me in this form is correct to the best of my knowledge and belief. I understand that any wilful misrepresentation of facts will result in my dismissal from the institute. If admitted, I shall abide by all the rules and regulations of the institute.

Date:

Signature:

Checklist (Send self attested photocopies(Not Original) and mention reference no. on each of the document)
1. Date of Birth (DOB) Certificate or High School (Class 10) Certificate with DOB 3. Certificate of Physical Disability (Type of disability to be attached) 2. SC/ST/OBC Certificate if applicable 4. Sponsorship Certificate for Sponsored Candidate

5. GATE/CSIR/UGC/ICMR/CEED/Other Fellow Exam Score card (If you have 6. Photocopies of qualifying degree marks/grade sheets not received GATE score card then please send printout of the online GATE score card.) 7. The application fee of Rs.400/ for candidates in General/OBC and Rs.200/ for 8. Printed copy of your Online filled application form (If photograph is not SC/ST/PD must be paid through demand draft payable to The Registrar IIT loaded, then write reference no at back of self attested passport size photograph Kanpur at Kanpur.(Note: Send original) and staple it.). 9. No Objection/relieving Certificate from Employer (For employed candidates 10. Two letters of reference (For Ph.D. applicants only) at the time of admission)

Mailing Address for Applications:

The Convenor, DPGC Department/Programme of _________________________ (Kindly mentioned the Department name where you are seeking your admission) Indian Institute of Technology, Kanpur Kanpur-208016 U.P.