ADMISSION 2013

SRM UNIVERSITY

ENGINEERING & TECHNOLOGY

Application Number

3530001

Application Submitted on:

27-Dec-2012

1.SIGNATURE
2. NAME OF THE APPLICANT
AVVARU HARI TEJ
3. GENDER

5.NATIONALITY

4. RELIGION

Indian

Hinduism
Male

Female

6.COMMUNITY

7. DATE OF BIRTH

General/OC OBC/BC/MBC

8. MOTHER TONGUE
Telugu 24

SC

13-Jul-1995

ST

9.NATIVE STATE

10.NAME OF PARENT/GUARDIAN

Andhra Pradesh 11

AVVARU UMA MAHESHWAR

11. ADDRESS FOR CORRESPONDANCE(DO NOT REPEAT NAME)

3/207-1,,dr.usha devi clinics, christian lane,
12. CITY

cuddapah

13. DISTRICT
Cuddapah
16.STD CODE

14.STATE

15.PINCODE

Andhra Pradesh 11
17.TELEPHONE NUMBER

516001
18.MOBILE NUMBER
8801186700

19. EMAIL ADDRESS

aharitej@hotmail.com

Application Printed Date: 27-Dec-2012

Page 1 of 2

[P.T.O]

ADMISSION 2013

SRM UNIVERSITY

20.DETAILS Xth AND XIIth STANDARDS

SCHOOL EXAM

BOARD/
UNIVERSITY

SCHOOL

XII standard
sri chaitanya jr.college, vijayawada.

X standard

PASSED
REGISTRATION
NUMBER

Andhra Pradesh
Board of Intermediate
Education 11

MONTH/YEAR

Not Required

Not required

Not Required

APPEARING

Not Required

% OF MARKS

01/04/2013

Not Required

88.30

21.DETAILS OF THE QUALIFYING EXAMINATION FOR UG/PG DIPLOMA PROGRAMS

PASSED
QUALIFYING
EXAM

COLLEGE

UNIVERSITY

REGISTRATION
NUMBER

APPEARING
MONTH/YEAR OF AGGREGATE
% OF MARKS
PASSING

22.PARENT'S OCCUPATION

23.PARENT'S INCOME (RS)

1,00,001 - 2,00,000

Doctor 42
24. PROGRAM APPLIED
GROUP-I
B.Tech

M.Tech

MBA

GROUP-II
B.Arch

24(a).OPTION FOR ONLINE EXAM

YES
NO

GROUP-I GROUP-III
B.Des

PGPM

PGPRM

M.ARCH

B.B.A

24(b).OPTION FOR PAPER/PENCIL EXAM

YES
NO

25.CHOICE OF ONLINE EXAM SLOT(ONLY FOR GROUP I)

27. BRANCH/SPECIALIZATION
1). 101-B.Tech.-Aerospace Engineering

26.TEST CITY CENTRE

Thirupathi 108

2). 112-B.Tech.-Genetic Engineering

3). 118-B.Tech.-Nanotechnology
28.DECLARATION
I hereby declare that I have carefully read the instructions and particulars supplied to me that the entries made in this application form are correct to the best of my
knowledge and belief. I note that the decision of the University is final in regard to selection for admission. If selected for admission, I promise to abide by the rules
and regulations of the University and the guidelines in the prospectus. The University shall have the right to expel me from the University at any time after
admission, provided it is satisfied that I was admitted on false particulars furnished by me or my antecedents prove that my continuance in the University is not
desirable. I agree that all disputes are subject to the jurisdiction of the courts at Chennai only. Fees Paid on counselling and admission will not be claimed back
under any circumstances.

SIGNATURE OF APPLICANT

201212274410850

Payment Status:

Successful

DATE:

VALID FOR THE ACADEMIC YEAR 2013-2014 ONLY

Application Printed Date: 27-Dec-2012

Payment TXN No:

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27-Dec-2012