SHAILESH J.

MEHTA SCHOOL OF MANAGEMENT (SJ

M.MGM
MSOM)
T
2013 Indian Institute of Technology Bombay
Master of Management Program (2013 - 2015)

ONLINE APPLICATION PRINTOUT

Registration CAT Registration Number Overall VA & LR QA & DI

ID Percentile Percentile Percentile
MGW9303784 SR8249225 93.01 85.52 94.36

PERSONAL DATA

Full Name: DHRUVKUMAR SONAGARA

Date of Birth: 16-6-1992
Gender: Male Please affix
your recent
Nationality: Indian passport size
photograph here
Landline Phone

Mobile: 8469982048
E-mail: djsonagara@gmail.com
Category: OBC-NC
Others [if any]:
Person With Disability: No
Army/Govt. Servant: No

3 JASRAJNAGAR
KEVIN
MAVDI BYPASS
Address for Correspondence: RAJKOT
City: Rajkot
State: GUJARAT
PIN - 360004

EDUCATIONAL DATA

Qualifying Degree Details

 Year of
Qualifying Degre Overal Clas Institute/Universi
Branch CPI Completio Rank
e l% s ty
n
DHARMSINH
CHEMICA
B.TECH. 7.55 2013 DESAI
L
UNIVERSITY

Semester Details

Year % of Marks/CPI % of Marks/CPI Year of

(Sem 1) (Sem 2) Completion
1st 6.91 7.84 2010
nd
2 7.53 7.61 2011
3rd 7.54 7.67 2012
th
4 7.75 APPEARING
5th[if Appl.]

Additional Degrees, if any

Name
Overall Year of
of Branch/Subject(s) Board/Institute/University
%/CPI/Class Completion
Degree

WORK EXPERIENCE

Total Duration [in months]: 0

From Date To Date
Duration
Organization Designation Responsibilities [MM- [MM-
[in months]
YYYY] YYYY]
EXTRA-CURRICULAR ACTIVITIES

Participation in Events like Sports/Cultural Events/Quiz etc. (from most important

to least)
Level: International, National, Inter-State, State, Inter-City, City, Inter-College,
College
Event Level and Rank Secured
NCC B CERTIFICATE

PAYMENT DETAILS

Transaction Ref. No. Issuing Bank, Branch Amount Transaction Date

45981713484 SBI Internet Banking 1000.0 25-1-2013

DECLARATION

I certify that the information provided by me in this application is correct to the best of my
knowledge.

Date: 26-1-2013 (Signature of the Applicant)

Instructions for filling and submission of ONLINE Application

Printout

Sending DD

o On completion of ONLINE Application Form, please submit the Demand Draft (if
not paid online) in person at the counter of Academic Office, IIT Bombay or mail
 by Registered Post or Speed Post only to

o The Deputy Registrar (Academic)

Academic Office
IIT Bombay
Powai, Mumbai-400 076

so as to reach the Academic Office, IIT Bombay on or before 28-1-2013. Write

"M.MGMT (2013 - 2015) ONLINE Application" on top of the envelope.
Also, write your name, registration ID and CAT registration number on backside
of demand draft.

Imp Notes:
For candidates who have paid online, no need of posting any document to the institute
now.
For candidates who have paid through DD, need to send only DD and no other
document.
Candidates need to send the printout of the online application form and duly attested
documents only when asked.

For your future reference, note down the following information:

o Application Registration ID.

o Date of ONLINE Application Printout posting

For any query, send email to admissions@som.iitb.ac.in quoting your Registration ID