VIT

UNIVERSITY
(Estd. u/s 3 of UGC Act 1956)

Vellore 632 014, Tamilnadu, India.

www.vit.ac.in
OFFICE OF THE DIRECTOR STUDENTS WELFARE

PROFORMA FOR NOMINATION OF BEST OUTGOING STUDENT AWARD (2014-15)

1.

NAME

2.

REG. No.

3.

PROGRAMME

4.

BRANCH

5.

SCHOOL

6.

BANK ACCOUNT DETAILS

AT VIT INDIAN BANK
:
CONTACT ADDRESS

7.

8.

:
:

a) Present Address with Phone No.

(From
to
)

b) Permanent Address with Phone No.

(with STD code)

c) Email ID

d) Mobile No.

ACADEMIC PERFORMANCE

SEMESTER
I

GPA

SEMESTER
V

II

VI

III

VII

IV

IX

GPA

X
CGPA Total
9.

a) PLACE OF PROJECT:

S.No
.

Title of the Project

Place of Project
Address for
Communication

Remarks

Page 1 of 9

b) PROJECT DETAILS (Describe about 200 words) (Enclose a separate sheet)

10.

ARE YOU REGISTERED WITH VIT PAT

: YES/NO

OFF CAMPUS PLACEMENT

IN CAMPUS PLACEMENT DETAILS (NAME ALL THE INTERVIEWS ATTENDED)

S.No.
i.

Name of the company

Remarks Selected

Dream Offer

ii.
iii.
iv.

10. PARTICIPATION IN CO & EXTRA CURRICULAR ACTIVITIES

I.

Member of Students Chapter (Duration / Year)

a)
b)
c)

II. Member of Students Club (Duration / Year)

a)
b)
c)

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III. 11. Participation in Co & Extra-Curricular Activities & Prizes Won (Duration / Year)

I.

Students Chapter

a)
b)
c)
II. Students Club
a)
b)
c)

12. Administrative Achievement - Students Council, Class Representatives, President of Students Chapters
& Clubs ( Please Mention the Year & Duration)
a)
b)
c)
d)
e)
f)
g)
h)

13. Academic Achievements (Endownment Awards, Scholarships, Papers Presentated in National &
International)

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14. Sports Achievements (Duration / Year)

a. Intramurals

b. Outside VIT (TIES Etc.)

15. Details Of Competitive Examination

S.No.

Name of the Exam

1.

CAT (Common Aptitude Test)

2.

MAT

3.

GATE

4.

G-MAT

5.

GRE

6.
7.

IELTS
(International English Language Testing
System)
TOEFL

8.

BEC

9.

NET, SLET, IAS, Defence Entrance,

Other services, Any other (specify)

Score

Year of
appearance

Remarks

10.

16. PROFICIENCY IN LANGUAGE (Please underline Mother Tongue)

S.No

Language

Speak

Read

Write
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.
1.
2.
3.
4.
5.

17. ADMISSION FOR HIGHER STUDIES (NATIONAL /INTERNATIONAL)

18. DETAILS OF ANY SPECIAL ACHIEVEMENTS (Enclose extra sheet if required)

19. ANY OTHER RELEVANT DETAILS YOU WANT ADD: (Enclose extra sheet if required)

20. PROGRAMME CHAIR REPORT:

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Mr./Ms. Registration No is a
nominee for best outgoing student award. This confidential Report may be submitted to Director Students
Welfare in a sealed cover, with name of student written on the cover.]

Signature:

Name In Capital Letter:

Designation:

21. PROCTORS RECOMENDATION

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Mr./Ms. Registration No is a
nominee for best outgoing student award. This confidential Report may be submitted to Director, Students
Welfare in a sealed cover, with name of student written on the cover.]

Signature:

Name In Capital Letter:

Designation:

22. DEANS RECOMENDATION:

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Mr./Ms. Registration No is a
nominee for best outgoing student award. This confidential Report may be submitted to Director , Students
Welfare in a sealed cover, with name of student written on the cover.]

Signature:

Name In Capital Letter:

Designation:

Please submit the enclosed recommendation letter from the School Director, Programme Manager,
Project Guide and Proctor directly to Director, Students Welfare, VIT University.
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23. DECLARATION:
I certify that the information furnished above factually correct and subject to verification. All the details given are
true to best of my knowledge.

(Signature of the Student)

Name In Capital Letter :

Registration No.

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