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