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JEE (Main) AcknowledgementPage

This document is an acknowledgement page for Harshit Pandey's application to the 2014 Joint Entrance Examination (Main). It provides his personal details like name, date of birth, category, address, as well as details about the exam such as chosen test centers and medium. It also includes information about his academic qualifications including the year and board for 10th and 12th class, percentage marks obtained, and school/college details.

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Mayank Nautiyal
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116 views1 page

JEE (Main) AcknowledgementPage

This document is an acknowledgement page for Harshit Pandey's application to the 2014 Joint Entrance Examination (Main). It provides his personal details like name, date of birth, category, address, as well as details about the exam such as chosen test centers and medium. It also includes information about his academic qualifications including the year and board for 10th and 12th class, percentage marks obtained, and school/college details.

Uploaded by

Mayank Nautiyal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Joint Entrance Examination (Main) - 2014 CENTRAL BOARD OF SECONDARY EDUCATION ACKNOWLEDGEMENT PAGE

Application No.
Personal Details
Name: Mother's Name: Father's Name: State of Eligibility: Gender: Nationality: Aadhaar Number (UIDAI): HARSHIT PANDEY HEMA PANDEY JAGDISH CHANDRA PANDEY UTTARAKHAND MALE INDIAN --

41033674
DO NOT SEND THIS PAGE TO CBSE.

CANDIDATES ARE REQUESTED TO RETAIN THE PRINTOUT OF ACKNOWLEDGEMENT PAGE FOR FUTURE REFERENCE.

Date of Birth: Category Person with Disability(PwD): Percentage of Disability: Are you the only child?: Place of Residence: You need scribe/reader ?:

26/07/1996 GENERAL NO -NO URBAN NO

Examination Details
Applying For: Examination Mode (B.Tech.): Question Paper Medium: 2nd Choice of Exam Centre: 4th Choice of Exam Centre: JEE(Main) Paper - 1 and Paper - 2 Both PEN AND PAPER BASED EXAMINATION ENGLISH PANT NAGAR HARIDWAR Examination Mode (B.Arch.): 1st Choice of Exam Centre: 3rd Choice of Exam Centre: PEN AND PAPER BASED EXAMINATION HALDWANI BAREILLY

Academic Details
Year of passing class 10th: School Board of class 12th/Qualifying Exam: Name of the Qualifying Examination passed / appearing: 2012 Place of 12th class schooling: Type of Institution of Class 12th/Qualifying Exam: TOWN PRIVATE Year of Passing or Appearing class 12th/Qualifying Exam: 2014

CENTRAL BOARD OF SECONDARY EDUCATION The final examination of the 10+2 system, conducted by any recognized central/ state Board, such as Central Board of Secondary Education, New Delhi; Council for the Indian School Certificate Examinations, New Delhi; etc. -YES Roll Number of Class 12th/Qualifying Exam: Mode of preperation: -SELF STUDY

Percentage of Marks in Class 12th/Qualifying Exam: Appearing for Improvement of Class 12th/Qualifying Exam: Name and Address of the School/College from where passed / appearing:

HERMANN GMEINER SCHOOL BHIMTAL

Candidate's Mailing Address


Address: City/Town/Village: State: Email Address: Land Line Number: DEVI BHAWAN MALLITAL BHIMTAL BHIMTAL UTTARAKHAND [email protected] -Locality: District: Pin Code: Mobile Number: BHIMTAL NAINITAL 263136 9410780912

Guardian Details
Qualification Father's/Guardian's: Mother's: MATRICULATE MATRICULATE Occupation PRIVATE SERVICE OTHERS (INCLUDING HOUSE WIFE) Annual Income UPTO 100000 --

Payment Details
Payment Mode: Exam Fee: Deposit Date: ICICI Bank e-Challan 1800 /18/12/2013 Transaction ID: Branch Name/Code: -DECLARATION I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. I have read and understood the JEE procedures for both JEE(Main) and JEE(Advanced) - 2014. I shall abide by the terms and conditions thereon. M380030 NA --

Images Uploaded by Candidate Photograph Signature Thumb Impression

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