MAULANA AZAD NATIONAL INSTITUTE OF TECHNOLOGY BHOPAL- 462003
(An Institute of National Importance)
ADMISSION FORM Form No 142330 ScholarNo Degree PH. D Dated Department ENERGY Councelling ROUND-1 VERIFICATION FORM 1. Name RUMA ARORA SONI 2. Category UN RESERVED 3. Documents required 4. Admission Through MEA NON SAARC 5. Nomination by G.O.I./ICCR Letter No. Dated 6. Medical Certificated Submitted No 7. Qualifying Exam M.TECH. Discipline NANOTECHNOLOGY Division/Grade 1ST 8. Admitted Category Verified & provisionally admitted to I semester PH. D, ENERGY , Signature Member Admission Committee I undertake to produce the following document upto ------------- date . Failing which the admission stands cancelled. Signature of candidate Signature of Father/Guardian Date Date 1 MAULANA AZAD NATIONAL INSTITUTE OF TECHNOLOGY BHOPAL- 462003 (An Institute of National Importance) Form No 142330 ScholarNo Dated Degree PH. D Department ENERGY PERSONAL DETAILS 1. Candidate's Full Name RUMA ARORA SONI 2. Candidate's Name In Hindi
3. Gender FEMALE 4. Father's Name GOVIND RAJ ARORA 5. Mother's Name VARSHA ARORA 6. Nationality INDIA 7. Community HINDU 8. Category UN RESERVED 9. Date of Birth 14-07-83 10. Birth Place MADHYA PRADESH , VIDISHA 11. State of Eligibility 12. Father's Occupation PRIVATE 13. Father's Designation BUSINESSMAN 14. Present Postal Address MIG-18, SECTOR 3A SAKET NAGAR, BHOPAL(M.P) 15. Contact No 0755-2485216 16. Email rumaarora14@gmail.com 17. Father's Annual Income 3 LAKHS 18. Candidate Marrital status MARRIED 19. Details of qualifying examination passed on the basis of which admission is sought. 10+2 scheme or equivalent I. Exam M.TECH. II. Name of Board / University RAJIV GANDHI PRODYOGIKI VISHWAVIDYALAYA III. Roll No 005NT10MT13 IV. Year & Month of Examination JUL-2012 V. Class / Division 1ST VI. Name of Institute Last Attended SCHOOL OF NANOTECHNOLOGY, BHOPAL VII. Last Institute Place MADHYA PRADESH , BHOPAL 2 Form No 142330 Student Name RUMA ARORA SONI Degree PH. D Department ENERGY 20.Educational Qualification Sr.No Exam/Degree Subject/Branch Year Of Passing Division/Grade Obtained Marks % of Marks 21. Whether candidate was a member of NCC/NSS No 22.Local Guardian Details I.Name ABHISHEK ARORA II.Relationship BROTHER III.Occupation ASSISTANT PROFESSOR IV.Address E-2/102, FORTUNE DIVINE CITY, PHASE - I,OPP. MISROD POLICE STATION, HOSHANGABAD ROAD, BHOPAL V.Phone No 9713920838 VI.Email abhishekarora08@gmail.com DECLARATION BY THE CANDIDATE I declare that: The information given on the previous pages is correct, if I am found guilty of giving wrong information, I am liable to disqualified for admission. If I am selected for admission, I promise to abide by the rules and regulations, statues, ordinance of the Institute and any changes incorporated there in from time to time to maintain discipline of the institute and the hostel. Place Signature of Candidate Date 3 Form No 142330 Student Name RUMA ARORA SONI Degree PH. D Department ENERGY DECLARATION BY THE PARANTS/GUARDIAN OF THE CANDIDATE I hereby solemnly and sincerely affirm that the statement made and information furnished in my sons/daughters/wards admission from, and also in all the enclose documents submitted by him/her are true. Should it, however be found that any information furnished there in is untrue in material particulars, I realize that he/she will forego his/her seat in the Institute. I promise to abide by any decision taken by the Director or Institute authorities for any branch of my son/ward. I also agree to meet the expenses, both in the institute and hostel, in connection with the studies on my ward during the entire course. I shall also hold myself responsible and compensative for any damaged caused by my ward either in the institute or in the hostel. I promise to promptly intimate the institute of any change in my address & arrange to receive promptly any communication from the institute. Place Signature of parents or Guardian Date 4