JSS MAHAVIDYAPEETHA

JSS ACADEMY OF TECHNICAL EDUCATION

JSS Campus, Uttarahalli-Kengeri Main Road, Bangalore-60

Photo

MENTORS RECORD
BRANCH:
A. STUDENT PERSONAL INFORMATION:
Date of Birth
Name of Student

dd mm

yy

Sex

Admitted under
Admitted
CET/
Blood
on
COMDEK/
group
Rank
Mangt /
Date

Branch

Changed
branch

Lateral

USN:
Category
GM / SC /ST/ SNQ /
Others

Communication
Skills
Spoken

Games

Hobbies

Others

Written

Mobile:
E-mail:
B. PARENTS OR GUARDIAN DETAILS:
Name of the Father:

Occupation

Designation

Mother:
Occupation

Designation

Name of Guardian (Local)

Occupation

Address for correspondence:

Permanent Address

Phone:
Mobile:
E-mail:
Address

Phone:
Mobile:
E-mail:

Designation
Phone:
Mobile:
E-mail:

C. MENTOR
Name of the Faculty

Designation

Address

Signature of the student

Phone No.

E-mail ID

Signature of the Mentor

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D. ACADEMIC DETAILS:
T1

IA Marks
T2 T3 Av

Jan-

July-

External Exam Marks

JanJulyJan-

July-

T1

IA Marks
T2 T3 Av

July-

Jan-

External Exam Marks

JulyJanJuly-

Jan-

T1

IA Marks
T2 T3 Av

Jan-

External Exam Marks

JulyJanJulyJan-

July-

T1

IA Marks
T2 T3 Av

July-

External Exam Marks

JanJulyJanJuly-

Jan-

Semester : I

Subjects with code

Total Marks Obtained

% of Marks & Class

Semester : II

Subjects with code

Total Marks Obtained

% of Marks & Class

Semester : III

Subjects with code

Total Marks Obtained

% of Marks & Class

Semester : IV

Subjects with code

Total Marks Obtained

% of Marks & Class
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2

T1

IA Marks
T2 T3 Av

T1

IA Marks
T2 T3 Av

T1

IA Marks
T2 T3 Av

T1

IA Marks
T2 T3 Av

Jan-

July-

External Exam Marks

JanJulyJan-

July-

July-

External Exam Marks

JanJulyJanJuly-

Jan-

Jan-

External Exam Marks

JulyJanJulyJan-

July-

July-

External Exam Marks

JanJulyJanJuly-

Jan-

Semester : V

Subjects with code

Total Marks Obtained

% of Marks & Class

Semester : VI

Subjects with code

Total Marks Obtained

% of Marks & Class

Semester : VII

Subjects with code

Total Marks Obtained

% of Marks & Class

Semester : VIII

Subjects with code

Total Marks Obtained

% of Marks & Class
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3

E. AGREGATE OF I VIII SEMESTER DETAILS (Total marks obtained in each semester):

I

II

III

IV

VI

VI

VII

VII

VIII

VIII

Avg.

Avg.

Degree Awarded

Degree Awarded
Class

F. EXTRA CURICULAR DETAILS:

Name of the Event

Date

Place

Recognition

Cultural Activities
Remark

Name of the Event

Date

Place

Recognition

Sports Activities
Remark

Name of the Event

Date

Place

Recognition

Co Curricular
Remark

G. PROFESSIONAL SOCIETY MEMBERSHIP, IF ANY

Society Name

Membership No.

validly

H. PALCEMENT DETAILS
Name of Company

I.

Designation

HIGHER STUDIES DETAILS

Cleared with GATE:

GRE :
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4

Salary

Joining Date

GMAT:
CAT:
PGCET
Specialization

Name of
University/Institute

Competitive Exam
Name
Ranking

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5

Admitted on