GOA UNIVERSITY

CAREER COUNSELLING & PLACEMENT CELL

REGISTRATION FORM FOR PLACEMENT FAIR 2013

(For Graduates)

1.  Name (in block letters)

2.  Address for Communication

3.  E-mail address

4.  Mobile No.

5.  Gender (M/F)

DD MM YY

6.  Age & Date of Birth

7.  Category (tick whichever applicable)

8.  Details of Academic Qualifications

No. / Qualification / Name of School/College / Subject/s / % of Marks/Grade
1. / S. S. C
2. / H. S. S. C.
3. / Degree

9.  Batch:

10.  Marks scored

Semester / % Marks/Grade obtained
I
II
III
IV
V
VI

11.  Core Papers offered at graduation

1 / 8
2 / 9
3 / 10
4 / 11
5 / 12
6 / 13
7 / 14

12.  Additional Skills acquired (Pl. specify)

1.
2.
3.
4.
5.

13.  Languages known (Please tick on your eligibility, specify ‘Other’, if any)

ENGLISH (√) / HINDI (√) / OTHER (√) / OTHER
Read / Write / Speak / Read / Write / Speak / Read / Write / Speak / Read / Write / Speak
Excellent / Good / Average (√)

14.  Fluency in English

Yes / No

15.  Work Experience (specify, if Yes)

16.  Extra Curricular Activities (specify, if any)

17.  Additional information (specify, if any)

Yes / No

18.  Are you willing to relocate outside Goa?

Signature

DECLARATION

I do hereby declare that the information given above is true to the best of my knowledge and belief.

Place: Signature

Date: