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Event : BAJA SAEINDIA 2013

Registration ID : 87858 Registration Details Team Name TEAM KIIT Institute KIIT UNIVERSITY Team Members # 25 Faculty Advisor Isham Panigrahi Team Captain Jayant Raj SAE Collegiate Club A/c SAEINDIAKIIT 50062549933

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Team Details # Name Engg. Branch SAE Membership ID Email ID jayantraj1@gmail.com Photograph

1 Jayant Raj

Mechanical 7110221142

2 Palash Bolia

Mechanical 7110221145

palashboliacoolz@gmail.com

3 Md. Asif

Mechanical 7110221783

mdasifkhan2013@gmail.com

4 Rohit Manglik

Mechanical 7110221787

rutzzz008@gmail.com

5 Rohit Tripathy

Mechanical 7110221169

rohit_tripathy619@yahoo.co.in

6 Abhishek Kumar Mechanical 7110221174 Manish Singh Kanwal

abhi.k.upadhyay@gmail.com

Mechanical 7110221786

manishkanwal33@gmail.com

8 Subrat Sarkar

Mechanical 7110221171

Krisna.subus@gmail.com

9 Parakh Kumar

Mechanical 7110221785

pauri81@gmail.com

10 Sanjay Singh

Mechanical 7110221983

sanjay.singh31290@gmail.com

11 Kumar Piyush

Mechanical 7110221143

piyush_tulsyan@yahoo.com

12

Praveen Kumar Mechanical 7110221977 Singh Mechanical 7110221984

prav9491@gmail.com

13 Abhishek Kotha Prithvi Chaithanya Mukesh Pratap Singh

abhishek.abhi90@gmail.com

14

Mechanical 7110221984

prithvi111thecreator@gmail.com

15

Mechanical 7110221780

mukeshvps2306@gmail.com

16 Irfan Ahmad

Mechanical A/F

irfanahmad67@gmail.com

17 Anmol Agrawal Mechanical A/F

anmol1771@gmail.com

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Registration Fees Transaction # Bank Branch State Amount

Declaration I hereby declare that all the information provided in the registration documents and online registration forms is correct to the best of my knowledge. Also, I declare that the team would undertake all activities without professional assistance. In case we are found to violate any rules and regulations as specified in the rulebook or otherwise, the team is liable to further action as per the decision of the EVENT Secretariat. The team shall adhere to the regulations and code of conduct as specified by Event Secretariat. The team shall also be liable to any loss of documentation / communication on part of discrepancy in the information as provided above.

Team Captain

Faculty Advisor

HOD/DEAN

Principal

Institute Seal/Stamp Date : Place

Enclosures:Pay Slip / Remittance slip from issuing bank Mail the duly signed and attested copy of this form along with Pay slip/Remittance Slip to saeindia_indore@saeindia.org Click to Print This Form | Download Registration Form

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