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Admission Appli CT A I On Form

The document is an application for the PhD program at Birla Institute of Technology, Mesra, detailing the personal and educational background of the candidate, Gaurav Kumar Mishra. It includes information on his work experience, family details, and educational history, along with a declaration of the accuracy of the provided information. The application also contains a payment receipt for the application fee.
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0% found this document useful (0 votes)
4 views3 pages

Admission Appli CT A I On Form

The document is an application for the PhD program at Birla Institute of Technology, Mesra, detailing the personal and educational background of the candidate, Gaurav Kumar Mishra. It includes information on his work experience, family details, and educational history, along with a declaration of the accuracy of the provided information. The application also contains a payment receipt for the application fee.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Birla Institute of Technology

Birla Institute of Technology Mesra


Campus - Mesra

BIT Mesra PhD MO 2025


Program Selection
BIT Mesra - First Year PhD (2025 - 2033) (MONSOON) - PHD-MO-25-93
1.
1 BIT Mesra - Department of Mechanical Engineering - PHD MECH
Personal Details
Personal Details
First name GAURAV
Personal email [email protected]
Mobile Number 9711692448
Middle Name KUMAR
Last Name MISHRA
Date of Birth 25/03/1988
Gender Male
Blood Group A positive (A )
Aadhaar Card No./ VID 770995283870
Religion Hindu
Nationality Indian
Alternate Contact Number 8595594878
Alternate Email [email protected]
State of Eligibility Jharkhand
Sponsorship No
Identification Mark A mole on chin
Kashmiri Migrant No.
Physically Disabled No
BIT Employee No.
Program Mechanical Engineering
Do you have Work Experience? Yes
Breif Details of Work Experience With over 10 years of cumulative experience in academics, I have honed my expertise in
mechanical engineering fundamentals, with a special focus on thermal engineering, material
science, and fluid dynamics.
Address
Current Address Line HOUSE NO 4 MANSAROVAR ENCLAVE NEAR HANUMAN MANDIR KATHAL MORE
RANCHI
Current Country India
Current State Jharkhand
Current City Ranchi
Current Pincode 835303
Is your permanent address same as current Yes
address?
Permanent Address Line HOUSE NO 4 MANSAROVAR ENCLAVE NEAR HANUMAN MANDIR KATHAL MORE
RANCHI
Permanent Country India
Permanent State Jharkhand
Permanent Pincode 835303
Parent Details
Mother
Full Name POONAM MISHRA
Email [email protected]
Mobile No 8595594878
Occupation HOUSE WIFE
Annual Income 2 LAKHS
Highest Qualification 710987
Father
Full Name DEV SHANKAR MISHRA
Email [email protected]
Mobile No 8595594878
Occupation RETIRED GOVT. OFFICER
Annual Income O
Highest Qualification 710988
Category Selection
Birla Institute of Technology
Birla Institute of Technology Mesra
Campus - Mesra

GEN
Education History
10th/Secondary School Certificate
Board Others
Other Board UP BOARD
Name of Institution PT. JLN IC
Passing Year 2002
Obtained Marks 400
Total Marks 600
Percentage 66.67
Subjects HINDI,ENGLISH,MATHS,SCIENCE,SANSKRIT,SOCIAL SCIENCE
No. of Attempts 1
12th/Higher Secondary Certificate
Board Others
Board Name / University UP BOARD
Passing Year 2004
Obtained Marks 304
Out Of 500
Percentage 60.8
Subjects HINDI,ENGLISH,MATHS,PHYSICS,CHEMISTRY
No. of Attempts 1
Graduation
Name of institution/ University AKTU LUCKNOW
Passing Year 2010
Obtained Marks 3672
Out Of 5000
Percentage 73.44
Subjects MECHANICAL ENGINEERING SUBJECTS
No. of Attempts 1
Post-Graduation
Name of institution IIT BHUBANESWAR
Qualification M. Tech.
Passing Year 2014
Obtained Marks 7
Out Of 10
Percentage 70.0
Subjects THERMAL ENGINEERING SUBJECTS
No. of Attempts 1
Upload Documents
10th Marksheet
12th Marksheet
Graduation Marksheet
Post Graduation Marksheet
Declarations
Birla Institute of Technology
Birla Institute of Technology Mesra
Campus - Mesra

Declaration: I hereby declare that all the information given by me in this application is true and correct to the best of my knowledge and belief. I
also note that if any of the above statements are found to be incorrect or false or any information or particulars have been suppressed or omitted
there from, I am liable to be disqualified. If selected, my admission will be liable to be cancelled without notice or compensation in lieu of notice. I
have read and understood the contents of the Admission Notification for the program applying on website. I hereby permit / do not permit (delete
one) the Institute to use, display or transfer any of the details furnished by me in this form for any other purpose, except for complying with the
admission formalities.
Undertaking by the Candidate: I will comply with the Institute's rules, standards and instructions for student behaviour as notified from time to time.
I hereby waive and release all claims against the Institute agents at a time when I am not under the direct supervision of the Institute or its agents
or arising out of my failure to remain under such supervision or to comply with such rules, standards and instructions, and I agree to indemnify the
Institute and its agents against any consequences thereof. I agree that the Institute shall have the right to enforce appropriate standards of conduct
and that it may at any time terminate my participation in the Institute's program for failure to maintain these standards or for any actions or conduct
which the Institute considers to be incompatible with the interest, harmony, comfort and welfare of other students. If my participation is terminated, I
give my consent to being sent home at my own (or my parent’s) expense with no refund of fees. All references in the agreement and release to the
Institute and its agents shall include the Institute Vice Chancellor, and all its Officers, Deans, Staff members, Chairpersons, Group leaders,
Employees, agents. All reference herein to the parents of the applicant shall include the legal guardian or other adult responsible for the applicant. I
agree that in case of any legal dispute concerning admission procedures, the same shall be subject to exclusive jurisdiction of Courts at Ranchi.
This agreement shall take effect from the time I am accepted by and confirmed in enrolment in the Institute.

Name of Candidate:
Signature of Candidate:
Date:

Name of Parent/ Guardian:


Signature of Parent/ Guardian:
Date:

Make Payment
Receipt No Amount Transaction Date
CTAZFJA1XLP2Q2N 1500.00 Apr 19, 2025 8:40 PM

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