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M.Tech/M.Pharm Application Form 2024

The document is an application form for the M.Tech. programme submitted by Sarvesh Kumar Mishra on March 24, 2024. He is applying for a full-time regular position in the Department of Civil Engineering with specializations in Structural, Geotechnical, Transportation, Environmental, Geoinformatics, Hydraulics, and Engineering Geosciences. The applicant has completed a BTech in Civil Engineering with a CGPA of 7.57 and has qualified the GATE exam with a score of 358.

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0% found this document useful (0 votes)
44 views2 pages

M.Tech/M.Pharm Application Form 2024

The document is an application form for the M.Tech. programme submitted by Sarvesh Kumar Mishra on March 24, 2024. He is applying for a full-time regular position in the Department of Civil Engineering with specializations in Structural, Geotechnical, Transportation, Environmental, Geoinformatics, Hydraulics, and Engineering Geosciences. The applicant has completed a BTech in Civil Engineering with a CGPA of 7.57 and has qualified the GATE exam with a score of 358.

Uploaded by

ROYAL ENFIELD
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Application Form for [Link]./[Link].

Programme

Application No.: 24100998


Date & Time of Submission: 02:45PM on March 24, 2024

1. Personal Information

FULL NAME : SARVESH KUMAR MISHRA


MOTHER's NAME : MADHURI MISHRA
FATHER's NAME : KRISHNA DEO MISHRA
Date of Birth : 08-08-1998
Email : mishrasarvesh857@[Link] Gender : Male
Nationality : Indian Category : GEN
Physically Challenged ? : No
Mobile Number : 8218317366
Correspondence Address: Vill-Lathiya kalan, Post-Shikarganj Tehsil-Chakia Disst-Chandauli Pin Coad-232103
Permanent Address : Vill-Lathiya kalan,Post-Shikarganj Tehsil-Chakia Disst-Chandauli Pin Coad-232103
State : Uttar Pradesh
COAP Registration ID: COAP24002128

2. Application Fee Details


Application Fee : 500
E-receipt no. : DUM4132148
Date of Payment : 2024-03-24

3. Programme Selection :
Registration Category : Full-Time Regular

3A. Select the Primary Programme you are applying for (Compulsory) :
Programme : [Link]
Department/School: Department of Civil Engineering
Discipline: Civil Engineering
Spec 1:STRUCTURAL ENGINEERING
Spec 2:GEOTECHNICAL ENGINEERING
Spec 3:TRANSPORTATION ENGINEERING
Spec 4:ENVIRONMENTAL ENGINEERING
Spec 5:GEOINFORMATICS ENGINEERING
Spec 6:HYDRAULICS AND WATER RESOURCES ENGINEERING
Spec 7:ENGINEERING GEOSCIENCES
3B. Additional Programme 1 : 3C. Additional Programme 2 :
Programme : null Programme : null
Dept/School:null Dept/School: null
Discipline: null Discipline: null
Spec 1:null Spec 1:null
Spec 2:null Spec 2:null
Spec 3:null Spec 3:null
Spec 4:null Spec 4:null
Spec 5:null Spec 5:null
Spec 6:null Spec 6:null
Spec 7:null Spec 7:null

Spec = Specialization
4. Details of GATE/GPAT (Mandatory for Full-Time Regular Category) :

GATE/GPAT Qualified : Yes Is Your GATE/GPAT Score Valid : Yes


Name of the Exam : GATE
Reg./Rollno. CE24S33036037
Exam discipline : Civil Engineering
Exam Year : 2024
Exam Rank : 10936
Exam Score : 358
5. Academic Details :
5A. Qualifying Degree details : 5B. Other Degree details :
Degree : UG Degree Degree :
Degree Status : Completed Degree Status :
Degree Name : BTech Degree Name :
University : DR.A.P.J ABDUL KALAM TECHNICAL
University UNIVERSITY
: UTTAR PRADESH
Discipline : Civil Engineering Discipline :
Exam Year : 2020 Exam Year :
% or CGPA : 7.57 % or CGPA :
5C. Intermediate (10+2):
Name of Certificate : INTERMDEIATE
Name of Board : U.P BOARD
Subjects : PHYSICS,CHEMESTRY, MATHS,HINDI,ENGLISH
Year of Passing : 2015
Final Aggregate % or CGPA: 78
5D. High School (10th):
Name of Certificate : HIGH SCHOOL
Name of Board : U.P BOARD
Subjects : MATHS,SCIENCE,ENGLISH,HINDI,SOCIAL SCIENCE,SANSKRIT
Year of Passing : 2013
Final Aggregate % or CGPA: 75.16

6. Work Experience(Mandatory if applying under sponsored category):


First Work Experience : Second Work Experience :
Period from : Period from :
Period to : Period to :
Organization : Organization :
Position : Position :

7. Declaration:
I declare that the information provided by me on this application form is correct to the
best of my knowledge and belief. I understand that any wilful misinterpretation of facts
will result in my disqualification and dismissal from the Institute if admitted.

Candidate signature

Application no.: 24100998


Date & Time of Submission: 02:45PM on March 24, 2024

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