User Id:

5143648

CANDIDATES ARE REQUESTED TO RETAIN THE PRINTOUT OF ACKNOWLEDGEMENT PAGE FOR FUTURE REFERENCE.

Personal Details
Name of Candidate:

SUDHEER CHOWDARY PENTYALA

Father's/Husband's/Guardian's
Name :

NARAIAH PENTYALA

Mother's Name:

SANDHYA RANI PENTYALA

Date of Birth:

30/Jul/1995

Candidate Gender:

Category:

General

State/Union Territory of
Caste/Tribe:

Serial Number of caste/Tribe:

Male

Caste/Tribe Name:

Nationality:

Indian

Other Nationality:

Person with Disability/Differently

Abled (PWD/DA):

Yes

PWD/DA Category:

Blindness or Low vision

Disability Percentage:

Greater or equal to 40 Percent

Do you require wheelchair

support at the test centre?:

No

Communication Address
HOUSE NO. 5-84
Address :

CHANDALURU J.PANGULURU MANDAL

PRAKASAM DISTRICT

State/Union Territory:

ANDHRA PRADESH

Other State/Union Territory:

Country:

India

Other Country:

City:

Prakasam

Pin Code:

Other Town/City :
Mobile Number:

523167

Other City With Other Country:

9494316781

Mobile Number (Alternate) :

9550394999

Email Address:

sudheerchowdary121@gmail.com

Email Address (Alternate) :

sudheerchowdary121@live.com

Exam Centre City Preferences

Preferred City 1:

Vishakapatnam

Preferred City 2:

Vijayawada

Preferred City 3:

Hyderabad

Preferred City 4

Nellore

Academics Details
SSC/10th Std/Equivalent Details
Aggregate marks:

91.50

Month/Year of Completion:

March

Total Marks Obtained :

549

Maximum Marks :

600

SSC/10th Std/Equivalent Board

Name

Andhra Pradesh Board of Secondary Education

2010

Other Board Name:

HSC/12th/Equivalent/Diploma Course Details

Course Type:

HSC

Aggregate Marks:

96.30

Total Marks Obtained:

963

Maximum Marks:

1000

12th/Equivalent Board Name:

Andhra Pradesh Board of Intermediate Education

Other Board Name:

Duration of Diploma Course:
University/Board/Other Authority
Name:
Discipline:

Mathematics and Science

Month/Year of Course
Commencement:

Other Discipline Name:

Month/Year of Completion: March

2012

Bachelor Degree Details

Are you in the final year of Bachelor Degree?

Yes

Have you completed Bachelor

Degree?

Total Duration of Degree:

4 Year
63.73

Current Semester:

Semester-7

Aggregate Marks:

Type of University/Institution:

State University

Other Type of University/

Institution:

State/Union Territory Where

University is Situated:

Andhra Pradesh

University Name:

J.N.T.U.

Other State/Union
Territory Where University
is Situated:

Other University Name:

Name Of College:

JAWAHARLAL NEHRU TECHNOLOGICAL UNIVERSITY KAKINADA

Degree Name:

B.Tech

Other Degree Name:

Discipline:

Engineering/Technology

Other Discipline Name:

Month/Year of Course
Commencement:

September

2012

Month/Year of Completion: April

2016

Other Professional Degree Details

Have you completed any professional degree such as CA/CS/ICWA
without completing Bachelor's Degree:

No

Specify Other Professional

Degree:
Professional Inter Marks:

Professional Final Marks:

Month/Year of Course
Commencement:

Month/Year of Completion:

Master Degree Details

Do you want to enter Master
Degree Details?

No

Master Degree Completion Status:

Duration:

Current Semester:

Aggregate Marks:

Type of University/Institution:

Other Type of
University/Institution:

State/Union Territory of
University:

Other State/Union
Territory of University:

University Name:
Other University Name:
Name of College/Institution:
Degree Name:

Other Degree Name:

Discipline:
Other Discipline Name:
Month/Year of Course
Commencement:

Month/Year of Completion:

Work Experience Details

Automobiles/Auto-ancillaries

Banking/Financial Services

Durables

Engineering/Industrial

Fast Moving Consumer Goods

(FMCG)

Information Technology

Pharmaceuticals/Healthcare

Retail

Telecommunications
Others1 (Work Area)

Others1 (Exp In Month)

Others2 (Work Area)

Others2 (Exp In Month)

Others3 (Work Area)

Others3 (Exp In Month)

Total Work Experience (In Months)

Programme Details

IIM Ahmedabad PGP

(Interview City 1)

Hyderabad

IIM Ahmedabad PGP

(Interview City 2)

IIM Ahmedabad PGP-FABM

Bangalore

IIM Ahmedabad FPM

IIM Amritsar PGP

Hyderabad

IIM Bangalore PGP

Bangalore

IIM Bangalore PGP EM

Bangalore

IIM Bangalore PGP PM

Bangalore

IIM Bodh Gaya PGP

Bangalore

IIM Bangalore FPM

IIM Calcutta PGP PGDM

Hyderabad

IIM Calcutta FPM

IIM Indore PGP

Hyderabad

Programme IIM Indore PGP

Mumbai

IIM Indore EPGP

Hyderabad

IIM Indore FPM

IIM Kashipur PGP

Bangalore

IIM Kashipur EPGPM

IIM Kashipur EFPM

Kashipur

IIM Kashipur FPM

IIM Kozhikode PGP

Hyderabad

IIM Kozhikode FPM

IIM Lucknow PGP

Hyderabad

IIM Lucknow PGP ABM

IIM Lucknow PGPSM

Hyderabad

IIM Lucknow FPM

IIM Nagpur PGP

IIM Raipur PGPWE

Raipur

IIM Raipur FPM

Bangalore

Hyderabad

Kashipur

Hyderabad

IIM Raipur PGP

Bangalore

IIM Raipur EFPM

Raipur

IIM Ranchi PGDM

Bangalore

IIM Ranchi PGDHRM

Bangalore

IIM Ranchi FPM

IIM Rohtak PGP

Bangalore

IIM Rohtak EPGP

Hyderabad

IIM Sambalpur PGP

Hyderabad

RGIIM Shillong PGPEX

Shillong

IIM Sirmaur PGP

Bangalore
Chennai

IIM Rohtak FPM

RGIIM Shillong PGP

Bangalore

RGIIM Shillong FPM

IIM Tiruchirappalli PGP

Bangalore

IIM Tiruchirappalli PGPBM

IIM Tiruchirappalli PGPHRM

Chennai

IIM Tiruchirappalli FPM

IIM Udaipur PGP

Bangalore

IIM Udaipur FPM

IIM Visakhapatnam PGP

Bangalore

DECLARATION
I hereby certify that the particulars given by me in this Application Form are true to my knowledge and belief. I certify that I fulfill the CAT
2015 eligibility criteria 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 territorial jurisdiction of city of Ahmedabad only.

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