AWB21145195

Birla Institute of Technology & Science,Pilani, Rajasthan

Work Integrated Learning Programmes Division
Application for Admission to MBA in Business Analytics (WADIC) for 20z2

For Office use only

ID No: 2022WB21 Date of Receipt:

Remarks,if any.

Dean Vice-Chancellor

Note:Please read the instructions carefully before filling in this application forn.
SECTION 1:PERSONAL INFORMATION & EDUCATIONAL BACKGROUND

1.Name: Avanigadda Maha Lakshmi

2.Gender: Female
3.Date of Birth: Jan. 26, 2001
4.Father's Name: Avanigadda Srinu
5.Mother's Name: Avanigadda Durga
6.Email: maha.avanigadda@wipro.com
7.Mobile/Phone: +91 63050 60172/+91 63050 60172
8.Nationality: Indian
9.Do you belong to Scheduled Caste or Scheduled Tribe?[Y/N] N
10.Address for Correspondence: G block 403
Vombay Colony
Ajith Singh Nagar
Vijayawada,Andhra Pradesh, India
11.WIPRO Employee ID:NA
12.Educational details from School Leaving Certificate onwards in chronological order:

Name
Total
Qualification of Subject/ Year of Maximum Final
Level Duration(Years) Marks Division
Diplomal Branch completion ICGPA
Marks Marks
Degree

Graduation COMPUTER
or equivalent
B.CA.
APPLICATION$
3 year 2021 7.78 3800 2958 1st division

ECONOMICS
10+2 level, 10+2 Level
AND 2 year 2018 8.99
Diploma 3 yr (Intermediate) |000 899 1st division
COMMERCE

10th level,
10th Grade 10th
matriculation
or equivalent
(Matriculation) MATRIcULATION year 2016 7.80
600 70 1st diision

AsCalculated for declaring result and award of Divislon by your Board/university.If marks are not awarded, giveCumuative Grade Point Average Or
ts eguvalent. Explain below the basiss on which your B. SC. /B.E. M. SG./M. C.A. (or equvalent)final percentage 0s Calculated (Cleary explain gaps,
ny in s separate Sheet) AWB21145195
43.Level at which you have studied
14.Are youcurrently enrolled for
Mathematics: Till Matriculation(Std. X)
degree or diploma in any
MYes.give
details specifying the Untversitylnstitution: (YN) N
University Institution name.programme completion of the same.
name,duration,date of joining the programme and likely date of

15.Have you ever been a student of

BITS.Pilani.(Yes/No)if ves.please write name of the degree and your lb No.
16.Exam Centre Choice: Chennai (Tamil Nadu)
Note: In case exam centre is not indicated the case of
insttute will unilaterally assign a Centre. The Institute is also free to dermand that students Corme to an Exam Centre other than the one indicated above. Furtherin
Dubai centre there wll be an additional exam centre foes, which
will be indicated at the time of admisSon.

17.Curent Employment Status: Employed

18.Total Work Experience: 0Years 10 Months 0days

19.Work Experience in Curent Organisation: 0 Years 10 Months 1days

(as on applica bledeadline to be counted ony trom the paint of completing BEMSC orequivalent)
20.Employment Details:sinco the year of completing BEMSc or eguivalent oive brief employment details below in reverse chronological order.

Start Date End Date

Name of Employer Designation held

Total Work Experlence calculated after completing BEIMSc or

equivalent

Clearly explain gaps,f any in a separate sheet

Provide the dates of start end of the employment period

21.Declaration by the Applicant

information given and statements made in various sections
given in this form and heretby declare that all the
Ihave carefully read the details and the instructions the condition that if information or statement were
found to be
are true to the best of my knowledge. I agree to
and parts of this Application Form and enclosures the Instiute will be to examine in detail my educational and.
cancelled. I understand that the objective of
wrong, my admission to BITS Would automatically be accommodate my Career aspirations within
with my employer's visualization of my current and future professional involvement to
professional background along
realize that in this process of matching, the Institute instead of rejecting my application for admission may
the framework of an appropriate leaming avenue. Ithus admitted,l promise to abide by the Rules
another degree programme l area of study for which I have not applied. If
even Suggest that Iwould be more suitable for outside the Institute which will interfere with its
made by the Institute and Ishall do nothing either inside or
and Regulations in force or those that may hereafter be allotted centre. If Iam required to Pilani for
the study schedule and in appearing in the examinations at
orderty working and discipline.Ipromise to be regular in In the case that I myself will be paying my fees / dues,I affirm that I will
any examination.,lshalltake permission from my employer for appearing in the same. decision of BITS Vice-Chancellor
Further, in all matters conceming the Institute and myself the
regularly pay fees/dues to the Institute during my programme.
shall be binding on me.

Place.
Date
Viayguada
26-06 -2023
Signature:,
Name: A. Moha Loam