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MAULANA AZAD NATIONAL INSTITUTE OF TECHNOLOGY BHOPAL- 462003(An Institute of National Importance)

ADMISSION FORM

Form No 142330 ScholarNo

Degree PH. D DatedDepartment ENERGY

Councelling ROUND-1

VERIFICATION FORM

1. Name RUMA ARORA SONI 2. Category UN RESERVED

3. Documents required

4. Admission Through MEA NON SAARC5. Nomination by G.O.I./ICCR Letter No. Dated

6. Medical Certificated Submitted No7. 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 Date1

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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 InHindi

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 Elig ibility

12. Father's Occupation PRIVATE

13. Father's Designation BUSINESSMAN

14. Present Postal Address MIG-18, SECTOR 3ASAKET NAGAR, BHOPAL(M.P)

15. Contact No 0755-2485216

16. Email rumaarora14@gmail.com

17. Father's Annual Income 3 LAKHS

18. Candidate Marritalstatus MARRIED

19. Details of qualifying examination passed on the basis of which admission is sought. 10+2 scheme or equivalent

I. Exam M.TECH.

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II. Name of Board / Universi ty 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. Las t Ins titute 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.AddressE-2/102, FORTUNE DIVINE CITY, PHASE - I,OPP. MISRODPOLICE 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

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to dis qualified for admis sion.If I am selected for admission, I promise to abide by the rules and regulations, statues, ordinance of the Instituteand any changes incorporated there in from time to time to maintain discipline of the institute and the hostel.

Place Signature of Candidate

Date3

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

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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 thathe/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 duringthe entire course. I shall also hold myself responsible and compensative for any damaged caused by my ward eitherin the institute or in the hostel.

I promise to promptly intimate the institute of any change in my address & arrange to receive promptly anycommunication from the institute.

Place Signature of parents or Guardian

Date4