1/24/2021 https://pessat.com/printform.aspx?

appno=109765

ADMISSIONS 2021

APPLICATION FORM

Personal details
Registration number 109765
Course name BTech

Name of the applicant SHRIYA J K

Gender Female

Date of birth 4-Aug-2003

Blood group B-Positive
Nationality Indian

Religion Hindu
Category GENERAL
Caste Arya Vysya

Mother tongue Telugu

Citizenship Indian
Family size Self + 4
Place of birth Bangalore

Handicapped No
Phone no 080-41711522
Mobile no 9036892715
Email ID jkpranava16@gmail.com

Details of address Permanent address Communication details

Parent/Guardian's name Krishna J s Krishna J s

No. 128/1, 5th West Main, ITI Layout, No. 128/1, 5th West Main, ITI Layout,
Address Kathariguppa Main Road, Banashankari Kathariguppa Main Road, Banashankari
3rd Stage 3rd Stage
City Bangalore Bangalore
State Karnataka Karnataka
Pincode 560085 560085

Details of parents Father Mother

Name krishna j s Dr. sailaja kasamsetty
Qualification B.E. MSc. , PhD
Occupation Service service
Designation Chief Electrical Engineer HOD of Biology Department
Employer details Sundaram Architects Sri Kumaran's Educational Institutions
Annual income 1000000 800000
Alumnus of PES No No

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Details of qualifying examination

Last institute studied name Sri Kumaran PU College

Last institute studied Address 1/1A, Kanaka Layout, Brindavan Layout, Padmanabhanagar,
City :Bangalore, State : Karnataka, Pincode : 560061

Last institute left (on or expected) 2021 Qualifying examination 12th State Board

Details of branch
Branch being sought Preference 1 : Computer Science
Preference 2 : Electronics and Communication
Preference 3 : Electrical & Electronics

Test centre preferences

1. Bangalore 2. Tumkur 3. Mysore

Other details
Residence Resident of Karnataka (KAR)

Admission through PESSAT

Payment type online payment

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