You are on page 1of 13

Date of Birth

MICA ID First Name Middle Name

Full Name Last Name (this name will be mentioned in Gender Date the diploma certificate)

307205 Aman

Chopra

Aman Chopra

Male

30

Date of Birth

Fa

Month

Domi Languages Year Religion cile Known State To read

Languages Known To write

Languages Known To speak

Address 1 Address 2

October 1987 Hindu

UP

KB-20 Hindi/English Hindi/English Hindi/English Sec14

Kaushambi

Father/Mother/Guardian

Address 3 City

Pin

State Tel No Off

Tel No Res. Fax

Email id Father/Mother/Guardian

Opp suman Petrol pump

Ghaziabad 201010 UP

9811413353 NA

NA

naveenchopra30@gmail.c om

Have you completed graduation Yes or No

If no, have you written the final exam Yes or No

If yes, when is the result due

Yes

NA

NA

Educational Qualification (Mention Title only Eg.: B.Com, M.Com. Etc.)

College/Place

University College Address

Have you ever stayed in hostel Yes or No

B.tech

Krishna institute of Engineering and Technology UPTU

KIET Meerut Highway (NH-58), P.Box-02 Ghaziabad-20120 NO

If yes, how many years

Do you have If yes work experience Organisation Place Area/Department Yes No

NA

Yes

1 2 3 Operations

Infosys Technologies Limited Bangalore

Have you studied communication/advertising /marketing as part of an academic programme Yes or No

Name & Address of If yes, Institute/University Institute/University which class/course

NO

NA

NA

NA

Do you have any special talent (painting/singing/dancing. etc.) If yes, please state

Will your Education at MICA be : Self-Financed

Financed through Educational Loan from any Bank / financial Institute

Dancing and Theatre

NO

Education Loan

If you have taken Educational Loan, please specify the name of Bank

Address of the Bank Amount of loan Repayment terms

Bank of Baroda

27/1 Vishwas Nagar Delhi - 110051

7.5 LPA

Course period + 1 year or 6 months after getting job whichever is earlier.

Do you suffer from any ailment that requires medical attention on a regular basis: Yes or No

Do any of your family members suffer from any of the following If yes, ailments: please specify Hyper the nature of tension / ailment Diabetes/ /Angina / Epilepsy / Any other (please Any Other specify)

If you have taken CAT/GMAT Coaching, please specify the name and address of the Coaching Class

NO

NA

Diabetes

NO

NA

Profession Fathers Name Qualification (Specify name of organization/designation)

Monthly Income: Above Rs. 75,000/Between Rs. 50,000/- and Rs. 75,000/Between Rs. 25,000/- and Rs. 50,000 Less than Rs. 25,000/-

Naveen Chopra BA and LLB

Business

Between Rs. 25,000/- and Rs. 50,000

Profession Mothers Name Qualification (Specify name of organization/designation)

Monthly Income: Above Rs. 75,000/Between Rs. 50,000/- and Rs. 75,000/Between Rs. 25,000/- and Rs. 50,000 Less than Rs. 25,000/-

Meenakshi Chopra

B.Com

IOCL

Between Rs. 50,000/- and Rs. 75,000/-

Local Contact Address Phone Email Name

NA

NA

NA

NA

You might also like