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41 views3 pages

Wa0007.

I CARD

Uploaded by

lavkumardixit
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
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SRM INSTITUTE OF SCIENCE AND TECHNOLOGY

(Deemed to be University u/s 3 of UGC Act,1956)


Ph.D Application Form - Calendar Session 2025-2026

Application No. : 2577103490


PERSONAL DETAILS
Applicant Name ARVIND PANWAR
Nationality Indian Have you studied from India : Yes
Mobile Number 9990676892 Emergency Mobile No. 9540765901
Email ID [email protected] Alternate Email ID [email protected]

Date of Birth 23-08-1980 Gender MALE


Aadhaar Number 317564599423 First Generation Learner No
How did you know about Friends/Relatives Are you differently abled No
SRMIST

Mode of Profession Academic Supervisor Name

Area of Interest Data Science

COURSE PREFERENCE
1- Ph.D.-Computer Science [Ph.D. - PART TIME EXTERNAL - SCIENCE AND HUMANITIES ] (Campus: Ghazhiabad)

EMPLOYMENT DETAILS (Applicable for Part Time only)

Employee Id 5515
Official Email Id [email protected]

Designation Asst. Proff,

Reporting Person Name Sh. Lav Dixit


Reporting Person Designation Head of Department

Reporting Person Official [email protected]


Organization Name R.D.Engineering College

Organization Address R.D. Engineering College NH 58 Duhai Ghaziabad

PARENT / GUARDIAN DETAILS


Father Name Krishna Pal Singh
Mother Name Sunita

Guardian Name

ADDRESS DETAILS
P187A
Address Line 1
Address Line 2 Sec 23

Address Line 3 Sanjay Nagar

District Ghaziabad Pin Code 201002

State Uttar Pradesh Country INDIA

ACADEMIC DETAILS
Under Graduation Educational Details
Current Education Qualification RESULT DECLARED
B.Sc
Institute Name
CHAUDHARY CHARAN SINGH UNIVERSITY, UTTAR PRADESH
Board
B.Sc - Mathematics Percentage
Degree & Specialization Marking Scheme
Percentage 54.62 Month & Year of June-2021

Registration No. BO46248 Mode of Study FULL TIME


Place of the Institution Baraut

Semester / Year Marks Obtained Maximum Marks


1 273.00 450.00
2 519.00 1000.00
3 792.00 1450.00

Post Graduation Educational Details


Current Education Qualification RESULT DECLARED

Institute Name IGNOU

Board INDIRA GANDHI NATIONAL OPEN UNIVERSITY, DELHI

MCA - COMPUTER SCIENCE Percentage


Degree & Specialization Marking Scheme
Percentage 62.44 Month & Year of June-2005

Registration No. 024432191 Mode of Study FULL TIME


Place of the DELHI

Semester / Year Marks Obtained Maximum Marks


1 369.00 600.00
2 763.00 1200.00
3 1116.00 1800.00

Additional Degree Details


Current Education Qualification RESULT DECLARED
M.TECH
Institute Name
Board CMJ UNIVERSITY, MEGHALAYA

MTECH - COMPUTER SCIENCE Percentage


Degree & Specialization Marking Scheme
Percentage 70.70 Month & Year of August-2012

Registration No. 70175510101159 Mode of Study FULL TIME


Place of the MEGHALAYA

Semester / Year Marks Obtained Maximum Marks


1 626.00 900.00
2 569.00 800.00
3 288.00 400.00
4 143.00 200.00

PAYMENT DETAILS
Mode of Payment Receipt Date ERP Receipt Id Bank Transaction Id Application Amount

Online 21-10-2024 189369 21336752378 1200.00

DECLARATION
I certify that the information submitted by me in support of this application, is true to the best of 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 ARVIND PANWAR

Parent / Guardian Name Krishna Pal Singh

Application Date 21-10-2024

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