By Register Post/ Speed Post Only

SSP-2014
[B.Tech-Other Discipline]

TO, The SSP-Co-ordinator Institute for Plasma Research, Near Indira Bridge, Bhat, Gandhinagar-382 428, Gujarat
From, Mr. Prasanth Madhurapantula Flat No 304, Sai Tirumala Towers, Street No 2, Hyderguda Hyderabad-500029 Andra Pradesh Contact No.:7731833444

INSTRUCTIONS: 1. This print out should contain the following pages. (a) Page 1 : This page contains Instructions for filling the application form and Address for correspondence (b) Page 2 & 3 : Application form that you have filled online. 2. Paste a 3.5cm x 4.5cm color photograph with plain background (this should be the same that you have uploaded during filling the application form). (a) Write your Unique application ID and name on the reverse side of your passport size photo. (b) Use good quality glue to ensure that the photograph does not separate from the application form. (c) Do not pin, staple, sign or attest the photograph. 3. Mailing Documents to IPR office. (a) Cut the Address Slip and paste it on an A4 size envelope (Do not fill address by hand or tamper the address slip). (b) In proof of your academic performance, attach all the PHOTOCOPIES of marksheets and supporting documents relevant to your honors and medals along with the application form. (c) Incomplete Application received will not be considered for selection. (d) Do NOT FOLD the application form. The form should be sent in an A4 sized envelope (e) Send the packet by Speed Post (preferably) or by Registered Post to the address mentioned in the address slip. The application packet should REACH on or before 21.03.2014. Forms received after 21.03.2014 will be rejected. 4. Kindly NOTE that online submission does not complete the application procedure. The hard copy must reach IPR. 5. Keep a photocopy of the completed application form for your reference. 6. Once the application form is submitted online, an application ID will be sent to your registered email-id which must be used for all future correspondence 7. For clarifications regarding online submission (if any) kindly send an email to iprssp@ipr.res.in mentioning your Application id.

INSTITUTE FOR PLASMA RESEARCH SUMMER SCHOOL PROGRAM-2014

Please paste your photograph here

Id:- 2338rapidly.reactive Please mention this number in all your correspondences with us

Applicant's Personal Details:

Name of Candidate: Email Address: Mobile Number: Contact Number: Address Mr.Prasanth Madhurapantula rapidly.reactive@gmail.com 7731833444 Flat No 304, Sai Tirumala Towers, Street No 2, Hyderguda Hyderabad-500029 Andra Pradesh

Qualification and Degree Details:

Presently Enrolled For: Engineering Discipline: Name of Institution / University Institution State Year Marks Obtained in % Gate/JSET/NET Qualified Awards / Honors / Medals received: B.Tech Other Discipline Nimra Institute Of Science And Technology Andra Pradesh 2014 71 NA

Academic Performance before M. Sc./ B.E./ B. Tech /B.Sc Engineering

Class XII Institute/Board Year Marks Obtained in % Class X Institute/Board Year Marks Obtained in % Board Of Intermediate Education, Andhra Pradesh 2010 66 Secondary School Certificate, Andhra Pradesh 2007 71

Other Details
How do You Know IPR? Internet/Web

Hostel Accommodation (Change in choice is not permissible under any circumstances)

yes

The applicant is a bonfide student of this department/Institue during the academic year "20__-20__" Date:__/__/____ Signature of HOD:______________________ Official Seal: