Student Application Form

Nirma University
INSTITUTE OF TECHNOLOGY ( ACADEMIC YEAR : 2024-25)
Bachelor of Technology
All India [ 12th Board Examination from a School Located Inside Gujarat ]
NU Application No : 24ITNUAI06408

Name : yug paresh vyas

Address : A 25 haridham tenament sama savli
road Vadodara GUJARAT INDIA 390008 Alternate Number : 6355467955
Alternate Email : pareshvyas51@gmail.com
Phone : 9426761637
E-mail : vyasyug1@gmail.com

Birth Date : 04/11/2005

Gender : MALE
Nationality : Indian

SSC / HSC Detail(s)

Board Passing Total Obtained

Qualification Name Location Stream Year Status Marks Marks Percentage

SSC CBSE Within - 2022 - 500.00 372.00 74.40

India

HSC CBSE Within SCIENCE 2024 PURSUING 0.00 0.00 0.00

India

Qualifying Examination Detail(s)

Exam Name : JEE (Main)-2024

JEE (Main)-2024 Application Number : 240310674389

Applicant's Aadhar Card Number : 321350428050

Program Preference(s)
 Branch Name Preference No.

Computer Science & Engineering (CSE) 1

Artificial Intelligence & Machine Learning (AI&ML) 2

Mechanical Engineering (ME) 3

Electronics and Communication Engineering (EC) 4

Civil Engineering (CL) 5

Electronics and Instrumentation Engineering (EI) 6

Candidate Document(s)

Document Name Upload Status Action

Candidate's Photo (Passport Size) Yes

View Document (../../CandidateUploads/Docu

Final NTA (CRL) JEE 2024 Score Card Yes

View Document (../../CandidateUploads/Docu

HSC (12th Std.) Marksheet Yes

View Document (../../CandidateUploads/Doc

JEE (Main) 2024 Admit Card (Session-I) Yes

View Document (../../CandidateUploads/Docu

JEE (Main) 2024 Admit Card (Session-II) Yes

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SSC (10th Std.) Marksheet Yes

View Document (../../CandidateUploads/Doc

Payment Detail(s) :

Payment Date Bank Name Amount Payment Mode Payment Status Transaction Ref no

30/Apr/2024 UPI 350.00 UNIFIED PAYMENTS SUCCESS 412145747134

I fully understand that filling the form does not guarantee admission to the said programme. For procedures for the admission
go through the academic regulation of the said programme available on the website.

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Student Signature
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