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Application Form Internship

This document is an application form for B.Tech/B.E. students at Visvesvaraya National Institute of Technology in Nagpur, India. It requests information such as the applicant's name, date of birth, contact details, JEE/AIEEE/SEEE rank, educational qualifications from secondary school through their undergraduate program, and space for any additional information. The applicant is asked to provide details of their secondary education, higher secondary education, and marks obtained in each semester of their undergraduate B.Tech/B.E. program.

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tanpreet_makkad
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0% found this document useful (0 votes)
41 views1 page

Application Form Internship

This document is an application form for B.Tech/B.E. students at Visvesvaraya National Institute of Technology in Nagpur, India. It requests information such as the applicant's name, date of birth, contact details, JEE/AIEEE/SEEE rank, educational qualifications from secondary school through their undergraduate program, and space for any additional information. The applicant is asked to provide details of their secondary education, higher secondary education, and marks obtained in each semester of their undergraduate B.Tech/B.E. program.

Uploaded by

tanpreet_makkad
Copyright
© Attribution Non-Commercial (BY-NC)
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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For B.Tech./B.E.

Students

Visvesvaraya National Institute of Technology, Nagpur 40010


Paste your recent
passport size
photograph

1. GENERAL
1.1 Name : _____________________
Surname

__________________ _
First name

______________________
Fathers Name

1.2 Date of Birth : ______________


1.3 JEE / AIEEE / SEEE Rank : _______________________________
1.4 Address for contacting : __________________________________________________________
_______________________________ PIN
Phone (R) ___________________________
1.5 E-mail Address: ________________________________
2. EDUCATIONAL QUALIFICATIONS

Mobile No. : _____________________

2.1 Secondary and / or Higher secondary


Marks
Examination

Board/Institution

Year of Passing

Obtained

Out of
(Total)

S.S.C. or Equivalent
H.S.S.C. or Equivalent
2.2 Under Graduation
Examination
Institution/University
Year of passing
Grade/ Marks
1 Sem. B.Tech/B.E.
2nd Sem. B.Tech/B.E.
3rd Sem. B.Tec/B.E.
4th Sem. B.Tech/B.E.
5th Sem. B.Tech/B.E.
6th Sem. B.Tech/B.E.
Total
3. ADDITIONAL INFORMATION , IF ANY
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
st

Date : __________________

Signature :______________
(Note: No additional sheet to be attached)

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