18/09/2015

CATForm2015

ThanksforsubmittingyourApplication
Form5005677whichcanbeusedforall
futurecorrespondence

Amount:
800.00
PaymentTransactionNo: DBMD4022962505

ApplicationDetails
Note: YourApplicationhasbeensubmittedsuccessfully.

ApplicationSummary

DownloadApplicationForm

RegistrationDetails
UserId:
NameofCandidate:
DateofBirth:
Country:
Email:
MobileNumber:

5005677
KHAIRKARANKITATUL
16/03/1993
India
ankitkhairkar@gmail.com
9786184220

PersonalDetails
FatherName:

ATULSARWOTTAMKHAIRKAR

MotherName:

MITRABINDAATULKHAIRKAR

Gender:
Category:
State/UnionTerritoryCastebelongs:
SerialNumberofCaste/Tribe:

Male
SC
Maharashtra
37

Caste/TribeName:

Mahar

Nationality:

Indian

PersonwithDisability/DifferentlyAbled
(PWD/DA):

No

CommunicationAddress
AddressLine1:

RoomNo.57GarnetBHostel

AddressLine2:

NITTrichy

AddressLine3:

TamilNadu

State:
Town/City:
Pincode:
AlternateMobileNumber:

TAMILNADU
Tiruchirappalli
620015
9561728186

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18/09/2015

CATForm2015

SSC/10thStd/EquivalentDetails
AggregateMarks:
SSC/10thStd/EquivalentBoardName:

92.00
MaharashtraStateBoardofSecondaryandHigherSecondaryEducation

TotalMarksObtained:

598

MaximumMarks:

650

Month/YearofCompletion:

March2009

HSC/12th/Equivalent/DiplomaCourseDetails
CourseType:
AggregateMarks:

HSC
67.00

TotalMarksObtained:

402

MaximumMarks:

600

HSCBoardName:
HSCDiscipline:
Month/YearofCompletion:

MaharashtraStateBoardofSecondaryandHigherSecondaryEducation
MathematicsandScience
February2011

BachelorDegreeDetails
AreyouinthefinalyearofBachelorDegree?:
TotalDurationofDegree:
CurrentSemester:
AggregateMarks(%):
TypeofUniversity/Institution:
State/UnionTerritoryofUniversity:
University/InstituteName:
NameofCollege/Institution:
DegreeName:
Discipline:

Yes
4Year
Semester7
71.50
NITs
TamilNadu
NationalInstituteofTechnology,Tiruchirapalli
NationalInstituteofTechnologyTiruchirapalli
B.Tech
Engineering/Technology

Month/YearofCourseCommencement:

July2012

Month/YearofCourseCompletion:

May2016

OtherProfessionalDegreeDetails
Areyoupursuingorhavecompletedany
professionaldegree,suchas,CA/CS/ICWA?:

No

MasterDegreeDetails
DoyouwanttoenterMasterDegreedetails?:

No

WorkExperience(Ifany)
TotalWorkExperience(InMonth):

Programmes
IIMAhmedabadPGPCity1:

Chennai

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18/09/2015

CATForm2015
IIMAhmedabadPGPCity2:

Bangalore

IIMAhmedabadPGPFABM:

Bangalore

IIMBangalorePGP:

Bangalore

IIMBangalorePGPEM:

Bangalore

IIMBangalorePGPPM:

Bangalore

IIMCalcuttaPGPPGDM:

Bangalore

IIMCalcuttaFPM:
IIMIndorePGP:

Kolkata
Bangalore

IIMIndorePGPMumbai:

Chennai

IIMIndoreEPGP:

Chennai

IIMKashipurPGP:

Chennai

IIMKozhikodePGP:

Chennai

IIMLucknowPGP:

Bangalore

IIMLucknowPGPSM:

Bangalore

IIMRaipurPGP:

Chennai

IIMRanchiPGDM:

Chennai

IIMRohtakPGP:

Chennai

IIMTiruchirappalliPGP:

Chennai

ExamCentreCityPreferences
PreferredCity1:

Tiruchirappalli

PreferredCity2:

Thanjavur

PreferredCity3:

Puducherry

PreferredCity4:

Chennai

PaymentDetails
PaymentMode:
Amount:
PaymentStatus:

online
800
S

UploadedDocuments
ToviewSC/ST/NCOBCCertificateClickhere.

Declaration
IherebycertifythattheparticularsgivenbymeinthisApplicationFormaretruetomyknowledgeandbelief.IcertifythatIfulfilltheCAT2015eligibilitycriteria
and undertake to produce original documents whenever necessary and I will not demand any reschedule of exam. I understand all disputes will be subject to
territorialjurisdictionofcityofIndoreonly.

CandidateSignature
Version10.00.01

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