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Govt.

Engineering College Ajmer


(An autonomous institute of Govt. of Rajasthan)
Training and Placement Cell
B. Tech. Student Data Base Form (2017)
Branch____________________________ College No. : __________________
Personal Details
Name ________________________________ Paste your
Fathers name ________________________________ picture here
and sign
Mothers name ________________________________
No. of brothers ____ No. of sisters ___
Date of birth (MM/DD/YYYY)

Height (in cms) ____ Weight (in Kg) _____ Blood Group _____
Vision Left Eye __Right Eye ___ Identification Mark __________________________
Mobile No. __________________ Fathers Mobile No._________________________
E-Mail ID: ____________________________Alt. E. Mail ID___________________
Summer Training (mention organization)___________________________________________
Training/ course on soft skills/ communication (mention name & duration)________________
Do you want any course/ training for improving your soft skills/communication. (Yes / No)
Interested in BPO,s (Yes/No): _____________________
Address
Permanent Address & Mobile No. Local Address & Mobile No

Educational Detail
X : RBSE/CBSE/Others______________ XII : RBSE/CBSE/Others _______________
X XII Diploma B. Tech. Semester wise Percentage No. of Backs Gaps Grace
(After
% YOP % YOP % YOP I II III IV V VI VII VIII Passive Active
Agg XII)

The information provided by me is true and correct, and I am responsible for all information mentioned
above and I will update my result within7 days of result declaration.

Signature of Student
Note : Students have to attach attested photocopy of mark sheets/proof of result.
The academic details mentioned above have been checked and verified.

(Faculty-in-charge)
Govt. Engineering College Ajmer
(An autonomous institute of Govt. of Rajasthan)
Training and Placement Cell
7
M. Tech. Student Data Base Form (2017)
Personal Details
Name ________________________________Branch__________ Paste your
picture here
Fathers name ________________________________ and sign
Mothers name ________________________________
No. of brothers ____ No. of sisters ___
Date of birth (MM/DD/YYYY)

Height (in cms) ____ Weight (in Kg) _____ Blood Group _____
Vision Left Eye________________Right Eye _____________
Mobile no. _____________________________________________
E-Mail ID: ____________________________________________
Summer training (mention organization)_____________________________________________
Training/ course on soft skills/ communication (mention name & duration)__________________
Do you want any course/ training for improving your soft skills/communication. (Yes / No)
Address
Permanent Address & Mobile No. Local Address & Mobile No.

Educational Detail
X XII Diploma B. E./ B. Tech M. Tech. Semester wise No. of Gaps Grac
Percentage Backs (Afte e
% YOP % YOP % YOP Agg % University YOP I II III IV Agg % r XII)

Whether apply for revaluation? If yes mention the semesters & subjects ______________________.
The information provided by me is true and correct, and I am responsible for all information mentioned
above.
Signature of Student
Note : Students have to attach attested photocopy of mark sheets/proof of result.
The academic details mentioned above have been checked and verified.

(Faculty-in-charge)
Govt. Engineering College Ajmer
(An autonomous institute of Govt. of Rajasthan)
Training and Placement Cell
M.B.A/M.C.A. Student Data Base Form (2017)
Personal Details
Name ________________________________Branch__________ Paste your
picture here
Fathers name ________________________________ and sign
Mothers name ________________________________
No. of brothers ____________ No. of sisters __________
Date of birth (MM/DD/YYYY)

Height (in cms) ____ Weight (in Kg) _____ Blood Group _____
Vision Left Eye________________Right Eye _____________
Mobile no. _____________________________________________
E-mail ID: ____________________________________________
Summer training (mention organization)_____________________________________________
Training/ course on soft skills/ communication (mention name & duration)__________________
Do you want any course/ training for improving your soft skills/communication. (Yes / No)
Address
Permanent Address Local Address

Educational Detail
X XII Graduation M.B.A/M.CA. Semester wise No. of Gaps Grace
Percentage Backs (After
XII)
% YOP % YOP Agg Stream/ YOP I II III IV V VI Agg
% %
University

Whether apply for revaluation? If yes mention the semesters & subjects ______________________.
The information provided by me is true and correct, and I am responsible for all information mentioned
above.

signature of student
Note : Students have to attach attested photocopy of mark sheets/proof of result.
The academic details mentioned above have been checked and verified.

(Faculty-in-charge)

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