VIT Application

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APPLICATION FORM FOR ADMISSION TO B.TECH.

PROGRAMMES - 2012 ( NRI / FOREIGN CANDIDATES ONLY) Full Name


Date of Birth Religion Community Campus Subject Studied Mobile No. Email-ID Programme Applied

: PRANAV MAKARAND DHONGADE


: 10/03/1994 : HINDUISM : GENERAL/OC : VELLORE : PCM : 0096599856933 : dhongade64@gmail.com : Option 1 :COMPUTER SCIENCE AND ENGG

Application. No. : 2012490368


Gender Nationality Mother Tongue Blood Group Hostel Landline Parent Email-ID : Male : INDIAN-NRI : MARATHI : O: YES : 00965 - 25630763 : mm.dhongade@invensys.com

: Option 2 :ELECTRONICS AND INSTRUMENTATION ENGG Permanent Address Educational Details Qualifying Exam Medium of Instruction Name of Board Name of the School Address of the School Father's Name Mother's Name Official Address Local Guardian Details Guardian Name Guardian Address Advertisement Details Enclose Photocopies of 1.X & XI Mark statement / XII or equivalent degree examination marks statement ( if passed out ). 2.Certificate issued by the employer, with full details of the designation of the parents. 3.Valid passport and visa copies of the candidate and the parents. 4.Sponsorship Letter ( To be given by the parents working abroad ). 5.Age proof certificate. Declaration I hereby declare that all the information given above are true to the best of my knowledge and I agree to the terms and conditions of VIT Unviersity. : MR. MILIND DHONGADE : 5, RUNANUBANDH SOCIETY, PARK AVENUE, OFF D.P. ROAD , AUNDH, PUNE, MAHARASHTRA - 411007. : OTHERS - RECOMMENDED BY FRIENDS : 12th Class or its Equivalent : ENGLISH : CENTRAL BOARD OF SECONDARY EDUCATION : FAHAHEEL AL WATANIEH INDIAN PRIVATE SCHOOL : AHMADI, KUWAIT, KUWAIT,- 61010. : MAKARAND MANIKRAO DHONGADE : GAURI MAKARAND DHONGADE Sponsor Details Occupation : FATHER : ENGINEERING SERVICE Mode of Study : REGULAR : INVENSYS ME FZE, C/O A.A. AL RASHED SONS & CO., P.O.BOX 242, SAFAT 13003., KUWAIT - 13003

Month & Year of passing: MAR - 2012

Reg.No. / Roll.No. : DSR127258900032

Parent / Guardian Details

: INVENSYS ME FZE , C/O A.A. AL RASHED SONS & CO. , P.O.BOX 242, SAFAT 13003. , KUWAIT - 13003.

Paste here firmly your recent colour photograph of good quality (SIZE 3.5 X 4.5 CM)

Date : Place:
( Signature of the parent / guardian ) ( Signature of the Applicant )

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