JOGINPALLY B.R.

ENGINEERING COLLEGE
MENTOR FORM

Name:
Affix latest
S/o / D/o: Passport size
Roll No: Batch: Photo
Year & Semester: Branch:
Day Scholar ( ) Hostler ( ) (Tick appropriately)
Permanent Address:

Temporary Address:

Student Mobile No (WhatsApp) :

Email ID:

A. PERSONAL INFORMATION

Date of Birth:

Sex:(√): M F

Identification Marks:

1.
2.
Height (cm): Weight (Kg): Blood Group:
Medical History, if any:
Reservation Category, if any:
B. ACADEMIC HISTORY UPTO INTER / DIPLOMA
Name of Board/University Year of Pass%/
S. No. Course
School/College Passing CGPA

1. SSC

2. Inter/Diploma

Achievements
3.

C. OTHER DATA
EAMCET/ECET Rank:
Management/ Counselling:
Mode of Travel to College: Own ( ) College Bus ( )
Bus Routes:
Place of Stay: Parent ( ) Guardian ( ) Hostel ( )
(If hostel, give hostel address & roommates information)
1.
2.

3.
C. FAMILY INFORMATION

Father Mother Guardian/Local

Guardian(Relation)
Name
Occupation
Qualification
Annual Income
(Approximately)
Address with E-Mail

Contact No
(Whatsapp)
Details of close relatives (i.e. siblings), if any, studying in the same college / other colleges
of JB Group

E. ADDITIONAL INFORMATION
1. Reading habits:
2. Co-Curricular activities:
3. Extra-Curricular Activities:
a) Literary Competitions:
b) Cultural Competitions:
c) Social Services:
d) Games/Sports
e) Others:

4. Inspiration/Goal/Ambition:

SELF DECLARATION:

I, S/O / D/O

ROLL NO here by solemnly and sincerely declare that

all the information given by me is true.

DATE: SIGNATURE OF THE STUDENT

 ACADEMIC PERFORMANCE
MARKS OBTAINED IN EACH SUBJECT: (1STYEAR - I SEM): AY
INTERNAL MID-I INTERNAL MID-II
AVG
NAME OF THE MARKS EXT MARKS/ P/F
S.NO TOTAL TOTAL CREDITS
SUBJECT GRADE
D O A D O A
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
(D-Descriptive, O-Objective, A-Assignment, P-Pass, F-Fail)

1STYEAR - I SEMSETER SUPPLEMENTARY

NAMEOF YEAR 1st ATTEMPT 2nd ATTEMPT 3rd ATTEMPT 4th ATTEMPT
S.NO THE & REMARKS
SUBJECT MONTH
MARKS/ MARKS/ MARKS/ MARKS/
P/F P/F P/F P/F
GRADE GRADE GRA DE GRADE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
 ACADEMICPERFORMANCE
MARKS OBTAINED IN EACH SUBJECT:(1STYEAR-II SEM):AY
INTERNAL MID-I INTERNAL MID-II
AVG
NAME OF THE MARKS EXT MARKS/ P/F
S.NO TOTAL TOTAL CREDITS
SUBJECT GRADE
D O A D O A
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
(D-Descriptive, O-Objective, A-Assignment, P-Pass, F-Fail)

1STYEAR - II SEMSETER SUPPLEMENTARY

NAMEOF YEAR 1st ATTEMPT 2nd ATTEMPT 3rd ATTEMPT 4th ATTEMPT
S.NO THE & REMARKS
SUBJECT MONTH
MARKS/ MARKS/ MARKS/ MARKS/
P/F P/F P/F P/F
GRADE GRADE GRA DE GRADE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
 ACADEMICPERFORMANCE
MARKS OBTAINED IN EACH SUBJECT:(2ndYEAR-I SEM):AY
INTERNAL MID-I INTERNAL MID-II
AVG
NAME OF THE MARKS EXT MARKS/ P/F
S.NO TOTAL TOTAL CREDITS
SUBJECT GRADE
D O A D O A
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
(D-Descriptive, O-Objective, A-Assignment, P-Pass, F-Fail)

2nd YEAR - I SEMSETER SUPPLEMENTARY

NAMEOF YEAR 1st ATTEMPT 2nd ATTEMPT 3rd ATTEMPT 4th ATTEMPT
S.NO THE & REMARKS
SUBJECT MONTH
MARKS/ MARKS/ MARKS/ MARKS/
P/F P/F P/F P/F
GRADE GRADE GRA DE GRADE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
 ACADEMICPERFORMANCE
nd
MARKS OBTAINED IN EACH SUBJECT:( 2 YEAR-II SEM):AY
INTERNAL MID-I INTERNAL MID-II
AVG
NAME OF THE MARKS EXT MARKS/ P/F
S.NO TOTAL TOTAL CREDITS
SUBJECT GRADE
D O A D O A
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
(D-Descriptive, O-Objective, A-Assignment, P-Pass, F-Fail)

2nd YEAR - II SEMSETER SUPPLEMENTARY

NAMEOF YEAR 1st ATTEMPT 2nd ATTEMPT 3rd ATTEMPT 4th ATTEMPT
S.NO THE & REMARKS
SUBJECT MONTH
MARKS/ MARKS/ MARKS/ MARKS/
P/F P/F P/F P/F
GRADE GRADE GRA DE GRADE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
 ACADEMICPERFORMANCE
rd
MARKS OBTAINED IN EACH SUBJECT:(3 YEAR-I SEM):AY
INTERNAL MID-I INTERNAL MID-II
AVG
NAME OF THE MARKS EXT MARKS/ P/F
S.NO TOTAL TOTAL CREDITS
SUBJECT GRADE
D O A D O A
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
(D-Descriptive, O-Objective, A-Assignment, P-Pass, F-Fail)

3rd YEAR - I SEMSETER SUPPLEMENTARY

NAMEOF YEAR 1st ATTEMPT 2nd ATTEMPT 3rd ATTEMPT 4th ATTEMPT
S.NO THE & REMARKS
SUBJECT MONTH
MARKS/ MARKS/ MARKS/ MARKS/
P/F P/F P/F P/F
GRADE GRADE GRA DE GRADE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
 ACADEMICPERFORMANCE
rd
MARKS OBTAINED IN EACH SUBJECT:( 3 YEAR-II SEM):AY
INTERNAL MID-I INTERNAL MID-II
AVG
NAME OF THE MARKS EXT MARKS/ P/F
S.NO TOTAL TOTAL CREDITS
SUBJECT GRADE
D O A D O A
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
(D-Descriptive, O-Objective, A-Assignment, P-Pass, F-Fail)

3rd YEAR - II SEMSETER SUPPLEMENTARY

NAMEOF YEAR 1st ATTEMPT 2nd ATTEMPT 3rd ATTEMPT 4th ATTEMPT
S.NO THE & REMARKS
SUBJECT MONTH
MARKS/ MARKS/ MARKS/ MARKS/
P/F P/F P/F P/F
GRADE GRADE GRA DE GRADE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
 ACADEMICPERFORMANCE
th
MARKS OBTAINED IN EACH SUBJECT:(4 YEAR-I SEM):AY
INTERNAL MID-I INTERNAL MID-II
AVG
NAME OF THE MARKS EXT MARKS/ P/F
S.NO TOTAL TOTAL CREDITS
SUBJECT GRADE
D O A D O A
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
(D-Descriptive, O-Objective, A-Assignment, P-Pass, F-Fail)

4th YEAR - I SEMSETER SUPPLEMENTARY

NAMEOF YEAR 1st ATTEMPT 2nd ATTEMPT 3rd ATTEMPT 4th ATTEMPT
S.NO THE & REMARKS
SUBJECT MONTH
MARKS/ MARKS/ MARKS/ MARKS/
P/F P/F P/F P/F
GRADE GRADE GRA DE GRADE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
 ACADEMICPERFORMANCE
th
MARKS OBTAINED IN EACH SUBJECT:(4 YEAR-II SEM):AY
INTERNAL MID-I INTERNAL MID-II
AVG
NAME OF THE MARKS EXT MARKS/ P/F
S.NO TOTAL TOTAL CREDITS
SUBJECT GRADE
D O A D O A
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
(D-Descriptive, O-Objective, A-Assignment, P-Pass, F-Fail)

4th YEAR - II SEMSETER SUPPLEMENTARY

NAMEOF YEAR 1st ATTEMPT 2nd ATTEMPT 3rd ATTEMPT 4th ATTEMPT
S.NO THE & REMARKS
SUBJECT MONTH
MARKS/ MARKS/ MARKS/ MARKS/
P/F P/F P/F P/F
GRADE GRADE GRA DE GRADE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
 SUMMARY OF BACKLOGS

NAME: BRANCH:

ROLL NO: SECTION:

YEAR & SEMSESTER: ACADEMIC YEAR:

S.NO. NO. OF BACKLOGS AS ON COUNSELLING MENTEE MENTOR

DETAILS SIGNATURE SIGNATURE
1.
2.
3.
4.
5.
6.
7.
8.

9.

10.
11.

12.
13.

14.
15.

16.
 STUDENTS – COUNSELLING

NAME: BRANCH:

ROLL NO: SECTION:

YEAR & SEMSESTER: ACADEMIC YEAR:

DATE COUNSELLING DETAILS MENTEE MENTOR

SIGNATURE SIGNATURE
 STUDENTS – COUNSELLING

NAME: BRANCH:

ROLL NO: SECTION:

YEAR & SEMSESTER: ACADEMIC YEAR:

DATE COUNSELLING DETAILS MENTEE MENTOR

SIGNATURE SIGNATURE
 STUDENTS – COUNSELLING

NAME: BRANCH:

ROLL NO: SECTION:

YEAR & SEMSESTER: ACADEMIC YEAR:

DATE COUNSELLING DETAILS MENTEE MENTOR

SIGNATURE SIGNATURE
 STUDENTS – COUNSELLING

NAME: BRANCH:

ROLL NO: SECTION:

YEAR & SEMSESTER: ACADEMIC YEAR:

DATE COUNSELLING DETAILS MENTEE MENTOR

SIGNATURE SIGNATURE
 PARENTS – CALL REGISTER

NAME: BRANCH:

ROLL NO: SECTION:

YEAR & SEMSESTER: ACADEMIC YEAR:

DATE CALL INFORMATION AND RESPONSE FROM PARENTS MENTOR

SIGNATURE
 PARENTS – CALL REGISTER

NAME: BRANCH:

ROLL NO: SECTION:

YEAR & SEMSESTER: ACADEMIC YEAR:

DATE CALL INFORMATION AND RESPONSE FROM PARENTS MENTOR

SIGNATURE
 PARENTS – CALL REGISTER

NAME: BRANCH:

ROLL NO: SECTION:

YEAR & SEMSESTER: ACADEMIC YEAR:

DATE CALL INFORMATION AND RESPONSE FROM PARENTS MENTOR

SIGNATURE
 PARENTS – CALL REGISTER

NAME: BRANCH:

ROLL NO: SECTION:

YEAR & SEMSESTER: ACADEMIC YEAR:

DATE CALL INFORMATION AND RESPONSE FROM PARENTS MENTOR

SIGNATURE