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    JEE (Main) AcknowledgementPage

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    swarup ghosh
    This document is an acknowledgement page for Swarup Ghosh's application to the Joint Entrance Examination (Main) - 2015. It provides Swarup's personal details like name, date of birth, category, address, as well as examination details like the test he applied for, exam medium and center choices. It also includes Swarup's academic qualifications like the year and board for class 10 and 12, percentage marks, and school details. Payment details like payment mode, transaction ID and fee amount are also listed.

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

    JEE (Main) AcknowledgementPage

    Uploaded by

    swarup ghosh
    31 views1 page
    This document is an acknowledgement page for Swarup Ghosh's application to the Joint Entrance Examination (Main) - 2015. It provides Swarup's personal details like name, date of birth, category, address, as well as examination details like the test he applied for, exam medium and center choices. It also includes Swarup's academic qualifications like the year and board for class 10 and 12, percentage marks, and school details. Payment details like payment mode, transaction ID and fee amount are also listed.

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    Original Title

    JEE(Main) AcknowledgementPage

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    This document is an acknowledgement page for Swarup Ghosh's application to the Joint Entrance Examination (Main) - 2015. It provides Swarup's personal details like name, date of birth, category, address, as well as examination details like the test he applied for, exam medium and center choices. It also includes Swarup's academic qualifications like the year and board for class 10 and 12, percentage marks, and school details. Payment details like payment mode, transaction ID and fee amount are also listed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    31 views1 page

    JEE (Main) AcknowledgementPage

    Uploaded by

    swarup ghosh
    This document is an acknowledgement page for Swarup Ghosh's application to the Joint Entrance Examination (Main) - 2015. It provides Swarup's personal details like name, date of birth, category, address, as well as examination details like the test he applied for, exam medium and center choices. It also includes Swarup's academic qualifications like the year and board for class 10 and 12, percentage marks, and school details. Payment details like payment mode, transaction ID and fee amount are also listed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    Joint Entrance Examination (Main) - 2015

    CENTRAL BOARD OF SECONDARY EDUCATION


    ACKNOWLEDGEMENT PAGE

    Application No.

    50669068
    DO NOT SEND THIS PAGE TO CBSE.

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

    Personal Details
    Name:

    SWARUP GHOSH

    Date of Birth:

    27/11/1996

    Mother's Name:

    SHILA GHOSH

    Category

    GENERAL

    Father's Name:

    SHIB SANKAR GHOSH

    Person with Disability(PwD):

    NO

    State of Eligibility:

    WEST BENGAL

    Percentage of Disability:

    --

    Gender:

    MALE

    Are you the only child?:

    NO

    Nationality:

    INDIAN

    Place of Residence:

    URBAN

    Aadhaar Number (UIDAI):

    257927249097

    You need scribe/reader ?:

    NO

    Examination Details
    Applying For:

    JEE(Main) Paper - 1 (B.E./B.Tech.) Only

    Mode of Examination:

    PEN AND PAPER BASED EXAMINATION

    Question Paper Medium:

    ENGLISH

    1st Choice of Exam Centre:

    KOLKATA

    2nd Choice of Exam Centre:

    HOWRAH

    3rd Choice of Exam Centre:

    DURGAPUR

    4th Choice of Exam Centre:

    SILIGURI

    Academic Details
    Year of passing class 10th:

    2013

    Year of Passing or Appearing class 12th/Qualifying Exam: 2015

    Place of 12th class schooling:

    CITY

    Type of Institution of Class 12th/Qualifying Exam:

    GOVERNMENT

    School Board of class 12th/Qualifying Exam:

    WEST BENGAL COUNCIL OF HIGHER SECONDARY EDUCATION

    Name of the Qualifying Examination passed / appearing:

    Any Public School/ Board/ University examination in India or in any foreign country recognized as equivalent to
    the 10+2 system by the Association of Indian Universities (AIU).

    Percentage of Marks in Class 12th/Qualifying Exam:

    --

    Roll No. of Class 12th/Qualifying Exam:

    --

    Appeared/Appearing for Improvement of Class


    12th/Qualifying Exam:

    NO

    Mode of preperation:

    SELF STUDY

    Roll Number of Class 12th/Qualifying Examination of


    Improvement Examination:
    Name and Address of the School/College from where
    passed/appearing:

    BALLYGUNGE GOVT HIGH SCHOOL 38/2 NARESH MITRA SARANI KOLKATA-700020

    Candidate's Mailing Address


    Address:

    A/90 RABINDRAPALLY

    Locality:

    BAGHAJATIN

    City/Town/Village:

    KOLKATA

    District:

    KOLKATA

    State:

    WEST BENGAL

    Pin Code:

    700086

    Email Address:

    [email protected]

    Mobile Number:

    9831855120

    Land Line Number:

    --

    Guardian Details
    Qualification

    Occupation

    Annual Income

    Father's/Guardian's:

    MATRICULATE

    PRIVATE SERVICE

    UPTO 100000

    Mother's:

    MATRICULATE

    OTHERS (INCLUDING HOUSE WIFE)

    --

    Payment Mode:

    Credit / Debit Card

    Transaction ID:

    ASMP3573440712

    Exam Fee:

    1000 /-

    Date of Transaction:

    29-11-2014 11:52:30

    Card Type:

    VISA/Master Card

    --

    --

    Payment Details

    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) - 2015. I shall abide by the terms and conditions thereon.

    Images Uploaded by Candidate


    Photograph

    Signature

    Thumb Impression

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