INDIAN INSTITUTE OF MANAGEMENT KOZHIKODE
Post Graduate Programme in Management 2023-25
PERSONAL DATA FORM
Instructions for completion of Personal Data Form
1. This data form is to be submitted online and save a soft copy of the PDF form for future reference
2. This data form is a key element of admission process. Complete and accurate reponses to the items are, therefore,
extremely important. Incomplete or false information will adversely affect your chances of selection. Admission granted on
the basis of false information will be ipso facto null and void.
3. In all matters relating to admission to the programme, the decision of the Institute will be final and binding on the
candidate.
SECTION 1: PERSONAL DATA
CAT Regn. No 22183901
CAT Score Card Uploaded
Name (As per CAT
GUGULOTHU KRISHNA CHAITANYA
application)
Gender Male
Category (As per CAT
ST (Uploaded)
application)
PwD(Yes/No) (As per CAT
No
application)
PwD Type (As per CAT
NA
application)
CONTACT DETAILS FOR FUTURE COMMUNICATIONS
Address Plot no 44 , flat no 501,karthik saurya arcade
Bhagya nagar co-op society, Near arjun theatre ,
Kphb ,Kukatpally ,Hyderabad 500072
Pin Code 500072
Phone No. 8008007551
Mobile No. 8008007551
SECTION 2: ACADEMIC RECORD
(A) Schooling
% of Marks
Standard Board/University Marksheet
Obtained
Xth (SSC) Telangana State Board of Intermediate Education 93.33 Uploaded
XIIth (HSC) Telangana State Board of Intermediate Education 95.3 Uploaded
(B) Graduation
i) DEGREE ONE
Degree Discipline Subject In Case of Engg. College University Marksheet Certificate
Name specify branch
Indian
Institute of Indian
Technology Institute of
ELECTRONICS
BTECH Engineering/Technology (Banaras Technology Uploaded Uploaded
ENGINEERING
Hindu BHU
University) Telangana
Varanasi
Year Year of Examination Percentage Score
1st Year 2018 65.3
2nd Year 2019 68.8
3rd Year 2020 70.9
4th Year 2021 75.2
5th Year
Bachelor's percentage filled in CAT 2022 application : 75.2
Bachelor's percentage as on 31 December, 2022: 75.2
Whether you have completed your Graduation? YES
(C) Professional Qualification (CA/ICWA/CS)
Professional Final Percentage filled in CAT 2022 application: Nil
Whether you have any CA/ICWA/CS qualification as on December 31, 2022? NO
Type of Professional Qualification:
CA/ICWA/CS Percentage as on December 31, 2022:
Marksheet: Not Uploaded
Certificate: Not Uploaded
(D) Professional Certification (CFA - Level 1, 2, 3)
Whether you have received any CFA certification? NO
(E) Post Graduation Qualification
Post Graduation Degree as per CAT application: NO
Do you have a Post Graduation Degree: NO
SECTION 3: WORK EXPERIENCE
FULLTIME REMUNERATIVE WORK EXPERIENCE AFTER GRADUATION/BACHELOR'S
(Do not include training or project work done as part of any curricular requirement)
i) Work Experience Details
Period(dd-mm-
Name of Reporting to yyyy) Monthly Experience
SNo Designation
Organization (Designation) Salary Certificate
From To
Software 19-07- 22-09-
1 Citrix manager 100000 Uploaded
Engineer 2021 2022
ii) Self Employment Details
Period (dd-mm-
Firm's Registration yyyy)
SNo Firm's Name Document Status Document Status
Number
From To
No Records Found
Total relevant work experience in months as on December 31, 2022 14.16
SECTION 4: CAREER PLANS AND EXTRA-
CURRICULAR ACTIVITIES
While a software engineer, I handled a lot of customer tickets where I
had to constantly and effectively communicate with clients. I started
Briefly outline your professional plans and
solving their problems and slowly developed a fascination for the
career objectives in your own words,
business side of the software industry. Through an MBA program, I
explaining and substantiating why you want to
would learn more about the business world and have a deeper
do this program and what you expect to get
understanding and its various functional areas. My ultimate goal is to
from it
be in an executive-level position where I can deliver innovative
solutions for clients.
I believe one of the main strengths I have is that I am good with people
and am an excellent team player. Being a part of a basketball team has
only made this more substantial.I am an optimist always find
Describe your strengths and weaknesses as something positive, even in the worst of situations.I wouldn't
identified by you. necessarily say that I have any specific weaknesses,but I am
constantly working on improving [Link] example,I always strive to
increase my efficiency and stay organized. Additionally,I am always
looking to learn new skills.
My ongoing self-development and drive to improve myself, I believe, is
my most significant accomplishment. I've taken on new challenges and
responsibilities throughout my professional experience, and I've always
What is your most significant accomplishment
worked to surpass expectations. I am always striving to be the greatest
so far?
version of myself, whether that is via learning new skills, seeking out
new experiences, or simply putting in the extra effort to create high-
quality work.
I am a passionate sports fan and keep up-to-date with the latest
happenings in various sports. I am a basketball player and love playing
basketball. I regularly play matches in my locality. I’m also fond of
WWhat are your present hobbies?
collecting shoes. I enjoy traveling, being outdoors, and taking long
rides on my bike. I also keep in touch with what’s happening in India
and the world and read a bit of non-fiction.
Any other information you would like to share
SECTION 5: UNDER GRADUATE ACADEMIC INSTITUTION
Under Graduate Academic Institution and Discipline Engineering
Indian Institute of Technology(Banaras
Academic institution
HinduUniversity),Varanasi
DECLARATION
I undertake that I have fully read the admission policy and understand that if my withdrawal causes shortfall in the
sanctioned intake of the programme, no fees will be refunded and no queries in this regard will be entertained by the
institute.
All the particulars mentioned in the registration form will be considered as final and no modifications will be allowed after
the last date specified for applying online. Applicants are requested to fill in the registration form with the utmost care and
caution as no correspondence regarding change of details will be entertained.
I agree that if any falsified records are detected during the selection process /programme / after completion of the
programme, the Institute reserves the right to debar from the selection process/ terminate from the programme/ revoke
the degree awarded.
I agree that I shall abide by the Rules and Regulations of the Institute. I also hereby undertake that I shall accept the
decision of the Institute as final if the seat allotted to me is cancelled due to submission of incorrect certificates or
terminate from the programme or revoke the degree awarded due to submission of incorrect information or document.
I Accept the declaration
Date: 05-02-2023 Name: GUGULOTHU KRISHNA CHAITANYA
Place: Hyderabad
Indian Institute of Management Kozhikode - Personal Data Form 2023
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