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    Mentor Mentee Form 2024

    Uploaded by

    parbhgill185
    Mentor mantee form

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Mentor Mentee Form 2024

    Uploaded by

    parbhgill185
    22 views3 pages
    Mentor mantee form

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

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    Mentor mantee form

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    22 views3 pages

    Mentor Mentee Form 2024

    Uploaded by

    parbhgill185
    Mentor mantee form

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 3

    Affix Photo of

    CT UNIVERSITY Mentee

    MENTEE RECORD CARD

    Name of the Mentor:……………………………………. UID:……………Contact Number……………….............


    Designation::…………………….. School: ……………………………Email id………………………………………

    1. Name of the Mentee: …………………………………….. UID No:………………..Gender……………..


    Category (Gen/OBC/SC/ST)……………… Religion…………………….. D.O.B………………………..
    Contact Number……………………………. Email ID ………………………………………..................
    Emergency Contact no……………………………..
    2. Programme: ………………………………………………………… Batch:………………………………

    3. Blood Group……………….. Aadhar Card Number……………………………………………

    Passport number in case of International Student……………………………………………….

    4. Father’s Name……………………………Contact Number………………….Occupation…………………

    5. Mother’s Name……………………………Contact Number………………….Occupation………………..

    6. Permanent Address………………………………………………………………………………………………….

    7. State (for National Students)…………………………….

    8. Nationality………………………………………………..

    9. Hostel/Day Scholar……………………......

    10. Any Health issue or Allergy (Y/N)…………Specify (if yes)……………………..……………………….

    11. Differently abled (Y/N)….…. Specify (if yes) …………………………………..Attach Proof (Tick)

    12. Education Detail:


    Board / Passing CGPA /
    Examinations Name of School/college Division Remarks
    University Year Marks (%)
    High School
    Inter / 10+2
    Graduation
    Others Specify)

    13. Total Family Members:…………………………..

    14. Sibling studying in CT University……………….

    15. Career Path: (Students must select any one option mandatorily)

    Industry Placement Research & Higher Studies Start-up & Incubation

    Signature of Student
    1. 1
    16. Achievements / Awards / Medals etc. If any
    S. No Name of the Award Year of Awarded Organized by

    17. Monthly Attendance (filled by Mentee)


    Particulars End of Aug End of Sep End of Oct End of Nov End Of Dec Overall
    % of Attendance

    Inform to Student/Signature

    Information to Parent/Signature

    18. Semester wise Attendance and Academic Performance (filled by Mentee)


    % of Backlog Subjects
    Sem Attendance SGPA CGPA S No. Subject Names
    I

    II

    III

    IV

    VI

    VII

    VIII

    IX

    Dated: ………..… (Signatures of the Mentee)

    Dated: ………..… (Signatures of the Mentor)

    1. 2
    RECORD OF MENTOR/MENTEE MEETINGS

    (MAINTAINED BY MENTOR/TEACHER/FACULTY)

    S. Initials of Initials of the


    Date Discussion points Follow up action
    No. the Mentee Mentor

    1.

    2.

    3.

    4.

    5.

    6.

    7.

    8.

    9.

    10.

    …………………………………..
    Verification by HoS (Semester End)
    Signature:………………………
    Name:……………………………
    UID:………………..……………
    Date:……………………………..

    1. 3

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