Scribd
Upload
65 views2 pages

SI UK Updated SIS 2022

This form collects personal, educational, and professional details from the student to submit university applications on their behalf. It requests accurate information as applications will be based on the provided details. Sections include personal details, immigration history if applicable, education background from high school onwards, work experience, and reference contact information. The student signs to confirm the collected information for application processing.

Uploaded by

premkumarance_999016
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
65 views2 pages

SI UK Updated SIS 2022

This form collects personal, educational, and professional details from the student to submit university applications on their behalf. It requests accurate information as applications will be based on the provided details. Sections include personal details, immigration history if applicable, education background from high school onwards, work experience, and reference contact information. The student signs to confirm the collected information for application processing.

Uploaded by

premkumarance_999016
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 2

SI-UK Student Information Sheet

By completing this form, I give permission to SI-UK to enter my information into application forms for
the courses and schools listed under University Choice.

KINDLY FILL ALL THE DETAILS WITH UTMOST CARE BECAUSE THESE ARE THE EXACT
INFORMATION BASED ON WHICH APPLICATIONS ARE MADE.

( SEND ONLY in WORD FORMAT)


Personal Details : As per your passport if you hold a passport.

Title (Mr/Miss/Ms/Mrs) : Ms
Given Name: Krithika Priyadarshini Surname: Sivasubramanian
Gender: Female Date of Birth: 15/02/1989
Nationality:Indian Country of Birth: India
Email:krithikace@gmail.com Phone Number:8248855739
Passport No. : H9601307 Passport start Date : 08/12/2010 end Date : 07/12/2020
Native Language :Tamil
Permanent home address (in English): 6/175, Samipuram Colony, Sivakasi East, Virudhunagar district - 626189
UK address including post code (if available):

Immigration Details (for students who had studied/worked in UK before)

Date of first entry to the UK:


Date of most recent entry to the UK:
Do you need a visa to stay in the UK? Yes
If the answer is yes,
1. What is your visa status?
2. When is your current visa expiry?
3. Have you ever been refused a visa to the UK?
Do you have other countries VISA Refusal (Leave blank if not applicable)

Refusal Details
Country Apply date Date of Refusal Reason for refusal
       
       
       

Education Background

Dates of study Name of Institution and Course Title Level of study, Final/ Predicted Full Time / Part
From (DD/MM/YY) Country (eg.NQF Level, Result’ Time
To (DD/MM/YY) High School, Percentage or
Bachelor, CGPA
Master)
M.Tech
SRM University, Construction
2011 - 2013
Chennai, India Engineering and Masters 9.486 Full Time
Management
Avinashilingam
2006 - 2010 university for Women,
B.tech Civil Bachelors 7.68 Full Time
Coimbatore, India
Chavara Vidya Bhavan
2005 - 2006 Matric.Hr.Sec.School,
12th grade 77.25% Full Time
Coimbatore, India
Chavara Vidya Bhavan
2003 - 2004 Matric.Hr.Sec.School, Full Time
10th grade 85.27%
Coimbatore, India

1
Work/Internship experience (if available): If you have two or three companies to be mentioned kindly
extend the same.

Job Title: Geo Physical Engineer


Name of organisation: Sun Geo Civil
Address of organisation: Bankura, West Bengal
Dates: From (DD/MM/YY) April 2017 To (DD/MM/YY) March 2022
Duties: Planning, Design and Drawing

Job Title: Assistant Professor


Name of organisation: B.S.Abdur Rahman University
Address of organisation: Vandalur, Chennai
Dates: From (DD/MM/YY) January 2014 To (DD/MM/YY) August 2016
Duties: Tutor

Job Title: Assistant Professor


Name of organisation: Saveetha Engineering College
Address of organisation: Thandalam, Chennai
Dates: From (DD/MM/YY) June 2013 To (DD/MM/YY) December 2013
Duties: Tutor

Job Title: Trainee Engineer


Name of organisation: Estate Civil Head Office
Address of organisation: IIT Kharagpur, West Bengal
Dates: From (DD/MM/YY) September 2010 To (DD/MM/YY) May 2011
Duties: Site Supervision, CADD drawings

References (One for UG, two for PG):As per your Letter of recommendations providers.

Reference 1
Title: Dr. Position: Assistant Professor
Name: L.Krishnaraj Phone number * : 9994782050
Work email *: krishnal@srmist.edu.in SI-UK e-reference:
Do you want to use an SI-UK e-reference?
Relationship to you: Teacher
How long has the person known you? 2 years
Name of Institution: SRM University
Address of Institution: Kattankulathur, Chennai
References 2
Title: Er. Position: Assistant Engineer
Name: Kazi Badruzzaman Phone number * : 7479045917
Work email * : kazi.jewel@gmail.com SI-UK e-reference:
Do you want to use an SI-UK e-reference?
Relationship to you: Former Colleague at IIT Kharagpur
How long has the person known you? 6 years
Name of Institution: Water Resources Investigation and Development Department, Govt of West Bengal
Address of Institution: West Bengal

Do you have a disability?


No NO Yes (please state)
Do you have any criminal convictions?
No NO Yes (please state)

Signature (As per your passport) :


Date :

You might also like