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    APPLIATION

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    kuppilinavya2
    The document contains a registration form for a PG entrance exam in Andhra Pradesh. It requests personal details like name, DOB, address, education history, category, annual income, test center preferences, payment details, and declaration from the candidate.

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    © All Rights Reserved
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    APPLIATION

    Uploaded by

    kuppilinavya2
    8 views1 page
    The document contains a registration form for a PG entrance exam in Andhra Pradesh. It requests personal details like name, DOB, address, education history, category, annual income, test center preferences, payment details, and declaration from the candidate.

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    © © All Rights Reserved

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    The document contains a registration form for a PG entrance exam in Andhra Pradesh. It requests personal details like name, DOB, address, education history, category, annual income, test center preferences, payment details, and declaration from the candidate.

    Copyright:

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

    APPLIATION

    Uploaded by

    kuppilinavya2
    The document contains a registration form for a PG entrance exam in Andhra Pradesh. It requests personal details like name, DOB, address, education history, category, annual income, test center preferences, payment details, and declaration from the candidate.

    Copyright:

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

    4/23/24, 1:47 PM about:blank

    1. PGECET Exam Paper For Entrance Test # : CE - CIVIL ENGINEERING


    2. (a) Qualifying Examination # : B.E./B.TECH Preserve the Registration Number for
    (b) Qualifying Degree Exam Hall Ticket No # : 20W61A0110 all future correspondence.
    (c) Year of App./Passing the Qualifying Exam : 2024 REGISTRATION NO. : 6410092654
    (d) Medium of Instruction at Qualifying Exam : English
    (e) Place of Study - Intermediate or Equivalent : URBAN
    3. (a) Candidate's Name # : KADUPURI NEERAJA
    (b) Father's Name # : KADUPURI RAJARAO
    (c) Mother's Name : KADUPURI DHANALAXMI
    (d) Date of Birth (as per SSC or Equivalent) # : 06/03/2002
    (e) Gender : FEMALE
    4. Category # : SC
    5. Local Area : AU
    6. (a) Non-Minority / Minority : NON-MINORITY
    (b) Minority Category : N.A
    7. Annual Income of the Parents (Rs.) : Below Rs 1 Lakh
    8. (a) Study Details :
    Inter 1st Year / Diploma 1st
    Class - 10 Srikakulam Srikakulam
    Year
    Inter 2nd Year / Diploma 2nd Degree 1st Year / Diploma 3rd
    Srikakulam Srikakulam
    Year Year
    Degree 2nd Year Srikakulam Degree 3rd Year Srikakulam
    Degree 4th Year Srikakulam
    (b) Place of Study - SSC or Equivalent : RURAL
    (c) SSC Hall Ticket Number & Year of Passing : 1705104946 , March - 2017
    (d) Inter/Diploma Hall Ticket No & Year of Passing : 2001310104 , March - 2020
    9. (a) Address for Correspondence : 3-86, KESAVARAOPETA VILLAGE SMPURAM POST,
    ETCHERLA MANDAL, Srikakulam,
    ANDHRA PRADESH, 532402
    (b)Contact Telephone Number (Mobile) : 6302922379 (c) E-Mail Id : [email protected]
    (d) Aadhar Card number : 638011374509
    10. Test Centre Preferences
    Preference - 1 Preference - 2 Preference - 3
    SRIKAKULAM VIZIANAGARAM VISAKHAPATNAM
    Preference - 4 Preference - 5 Preference - 6
    KAKINADA RAJAHMUNDRY VIJAYAWADA
    11. (a) Fee particulars - Payment through : ONLINE (c) Amount (in Rs.) : 1217.70
    (b) Payment Reference Id. : P641039415B9
    # - These Fields CANNOT be edited by candidate, but written request can be made to the CONVENER or Regional Coordinator of AP PGECET - 2024 or email to
    [email protected] Remaining fields can be edited by the candidate during the permitted period. For any details contact at 7382058455.

    Declaration : 1) I have carefully gone through the instruction booklet and I am conversant with the instructions. I shall abide by the eligibility conditions
    and other regulations to be satisfied for appearing at the entrance test and admission into any course prescribed. Further, I assure that, I will
    not involve in any malpractise or illegal activities in the entrance test. In case, I have furnished any false information or involved in any
    malpractise or illeagal activities, I am liable for punishment as per the existing law.
    2) I am responsible for the corrections of the above details filling by me and the CONVENER AP PGECET - 2024 is not responsible in
    anyway.
    Date : 23/04/2024 01:45 PM
    SIGNATURE and LEFT HAND THUMB impression of the candidate to be done in the presence of the Invigilator on
    the day of Examination in the Examination Hall
    Affix a recent color
    photograph (3.5 cmX3.5 cm) SIGNATURE OF THE CANDIDATE
    and get attested by a in the presence of the Invigilator
    Gazetted Officer or the Left Thumb Impression
    Principal of the College
    where studied (Well in
    advance BEFORE
    EXAMINATION)

    Note : 1) ALL the candidates have to submit this form in the Examination Hall to the Invigilator.
    2) Candidates are not allowed into the Examination Hall even if they are LATE BY A MINUTE.
    3) This is computer Generated sheet and does not require the signature of the CONVENER, AP PGECET - 2024

    about:blank 1/1

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