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    JEE (Main) AcknowledgementPage

    Uploaded by

    Karan Tejwani
    This document is an acknowledgement page for Karan Tejwani's application to the Joint Entrance Examination (Main) - 2018. It provides his personal details like name, date of birth, category, as well as examination details regarding the test medium and exam center choice. It also includes academic details regarding Karan's schooling, qualifying exam, percentage, and coaching institute. The page confirms receipt of Karan's application and 500 rupee payment via electronic gateway on December 5, 2017.

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    JEE (Main) AcknowledgementPage

    Uploaded by

    Karan Tejwani
    43 views1 page
    This document is an acknowledgement page for Karan Tejwani's application to the Joint Entrance Examination (Main) - 2018. It provides his personal details like name, date of birth, category, as well as examination details regarding the test medium and exam center choice. It also includes academic details regarding Karan's schooling, qualifying exam, percentage, and coaching institute. The page confirms receipt of Karan's application and 500 rupee payment via electronic gateway on December 5, 2017.

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    JEE(Main) AcknowledgementPage

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    This document is an acknowledgement page for Karan Tejwani's application to the Joint Entrance Examination (Main) - 2018. It provides his personal details like name, date of birth, category, as well as examination details regarding the test medium and exam center choice. It also includes academic details regarding Karan's schooling, qualifying exam, percentage, and coaching institute. The page confirms receipt of Karan's application and 500 rupee payment via electronic gateway on December 5, 2017.

    Copyright:

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

    JEE (Main) AcknowledgementPage

    Uploaded by

    Karan Tejwani
    This document is an acknowledgement page for Karan Tejwani's application to the Joint Entrance Examination (Main) - 2018. It provides his personal details like name, date of birth, category, as well as examination details regarding the test medium and exam center choice. It also includes academic details regarding Karan's schooling, qualifying exam, percentage, and coaching institute. The page confirms receipt of Karan's application and 500 rupee payment via electronic gateway on December 5, 2017.

    Copyright:

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

    Joint Entrance Examination (Main) - 2018

    CENTRAL BOARD OF SECONDARY EDUCATION


    ACKNOWLEDGEMENT PAGE

    Application No. 80106598


    DO NOT SEND THIS PAGE TO CBSE.
    CANDIDATES ARE REQUESTED TO RETAIN THE PRINTOUT OF ACKNOWLEDGEMENT PAGE FOR FUTURE REFERENCE.

    Personal Details
    Name: KARAN TEJWANI Date of Birth: 22/09/2000
    Mother's Name: HEENA TEJWANI Category GENERAL
    Caste Name NA Father's Name: KAILASH TEJWANI
    Person with Disability(PwD): NO State of Eligibility: GUJARAT
    Percentage of Disability: -- Gender: MALE
    Are you Diabetic :: NO Nationality: INDIAN
    Place of Residence: URBAN You need scribe/reader ?: NO

    Examination Details
    Applying For: JEE(Main) Paper - 1 (B.E./B.Tech.) Only
    Mode of Examination: COMPUTER BASED EXAMINATION Question Paper Medium: ENGLISH
    Choice of Online Exam Centre: SURAT

    Academic Details
    Year of passing class 10th: 2016 Place of 12th class schooling: CITY
    Year of Passing or Appearing class 12th/Qualifying Exam: 2018 Type of Institution of Class 12th/Qualifying Exam: PRIVATE
    School Board of class 12th/Qualifying Exam: CENTRAL BOARD OF SECONDARY EDUCATION
    Name of the Qualifying Examination passed / appearing: 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.
    Percentage of Marks in Class 12th/Qualifying Exam: -- Roll No. of Class 12th/Qualifying Exam: --
    Appeared/Appearing for Improvement of Class NO Mode of preperation: COACHING
    12th/Qualifying Exam:
    Roll Number of Class 12th/Qualifying Examination of
    Improvement Examination:
    Name and Address of the School/College from where Scholar English Academy R.S.No.104, Surat - Dumas Rd, NRTGB Hotel, Magdalla, Surat, Gujarat 395007
    passed/appearing:

    Candidate's Mailing Address


    Country: India State: GUJARAT
    District: SURAT Address: 8-a Megha tower 2, opposite joggers park
    Locality: union park lane, ghod dod road City/Town/Village: surat
    Pin Code: 395001

    Guardian Details
    Qualification Occupation Annual Income
    Father's/Guardian's: POST GRADUATE GOVERNMENT SERVICE RS. 800001 AND ABOVE
    Mother's: GRADUATE OTHERS RS. 200001 - 300000

    Payment Details
    Provider Name: ICICI Bank Payment Mode: Electronic Payment Gateway
    Fee Type: Examination Fee Transaction Amount: 500 /-
    Transaction ID: 416173712 Date of Transaction: 05-12-2017 23:27:20

    Selected Date for Computer Based Examination of Paper-1


    Your selected date for Computer Based Examination: No date is selected.
    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) - 2018. I shall abide by the terms and conditions thereon.

    Images Uploaded by Candidate


    Candidate Photograph Candidate Signature Parent/Guardian Signature

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