PROFESSOR L. K. MAHESHWARI FOUNDATION, PILANI

Office: EEE Group, BITS-Pilani, Rajasthan-333 031

Girl Student Of The Year 2013

(To be filled by self/others)

A.Information about Nominee

Name:

Date of Birth: Sex:

Identification Number:

Dualite/ Single Degree:

Contact No:email id:

Recommended By: (Please mention the name of the faculty and attach the recommendation letter along with this application)

Overall CGPA( Please attach a copy of latest EL sheet/ Transcript):

Core EEE/E&I GPA (Only courses pertinent to EEE/E&I):

Special Electives done (EEE/E&I):

Name of Course / Grade

Projects undertaken and a brief description:

Project Title / Supervisor Name and institutions / Grade / Brief description
Project-1
Project-2
Project-2

Please provide an account of the activities you have taken up during your tenure with EEE/E&I Association since joining BITS-Pilani

S No. / Year

1

/ 1st Year (2nd Year for dualites)

2

/ 2nd Year (3rd Year for dualites)

3

/ 3rd Year (4th Year for dualites)

Has any of your research/ articlebeen published(or presented) in (Department magazine/ in other institutes or in conferences etc.)? If yes please provide an account of the same. Attach a copy of each

S No. / Name of Magazine/ Conference/ Seminar / Year / Title of paper/ article

1)Have you ever participated in BOSM since joining BITS-Pilani? if yes please provide an account on the events you participated and any accolades you might have won. Attach a Xerox copy of each award/ certificate

2)Have you ever participated in OASIS since joining BITS-Pilani? if yes please provide an account on the events you participated and any accolades you might have won. Attach a Xerox copy of each award/ certificate

3)Have you been part of any departments or clubs (apart from EEE/E&I Assoc) since joining BITS-Pilani? Please provide an account of the role and position held in each of them

Department/ Club / Role and position

4)Please provide a list of your passions and hobbies:

S No.

While on campus, have you received an award/ medal/ exemplary certificate in academics, paper publication, projects, and sports? If yes, please provide details. Attach a Xerox copy of each award/ certificate

Have you ever faced a disciplinary action since joining BITS-Pilani? If yes, please provide details

Please provide a one page write up on why you feel you deserve the Girl Student of the Year 2013.

Signature of the applicant with Date

Information about Nominating person, if candidate is being nominated

Name:
Contact information( mobile No./e-mail id /address):
Designation and Qualification:
Interaction mode/ relation with Nominee:

Endorsement by Nominee( Please write a brief on the professional contributions of your nominee which makes him suitable for the award):

Signature & Date