Ip College Ug Form

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CHAUDHARY CHARAN SINGH UNIVERSITY, MEERUT

Under-Graduate (UG) Admission Registration Form


SESSION 2022 - 2023
Registration # 22G0085348 Reg. Date : 6 August, 2022 05:51 PM

1. Candidate Name : VISHU MITTAL


2. Father's Name : GOPAL MITTAL
3. Mother's Name : SAVITA MITTAL
4. Date of Birth : 19-Oct-2002 5. Gender : MALE
6. Caste/Category : Unreserved 7. Reservation : Not Applicable
8. Caste Certificate #: 9. Income Grp : Between 2.5 Lac to 4.5
Lac per annum
10. Domicile : Uttar Pradesh 11. Religion : Hindu
12. Domicile Cert. #: 13. Is Minority : NO
14. Nationality : INDIAN 15. Other Cat. : Not Applicable

16. Sports Quota Opted: No 17. EWS Status : Not Applicable

18. Address for Correspondance : 19. Permanent Address :

L
GOPAL WELDING AND HARDWARE STORE, KALI GOPAL WELDING AND HARDWARE STORE, KALI
NADI NADI
Bulandshahr Bulandshahr
Uttar Pradesh Uttar Pradesh
NA
PIN Code : 203001 PIN Code : 203001

20. Mobile : 8630681480 21. Email : [email protected]

22. Weightages Claimed :


Weightage Add %

23. Academic Record :


FI

Examination Year Max Obt. Roll No. Stream Board %


Highschool 2020 600 443 21136842 N/a Central Board of Secondary Edu. 2, Co... 73.8

Intermediate 2022 600 544 21631522 Commerce Central Board of Secondary Edu. 2, Co... 90.6
Subjects: ENGLISH CORE,BUSINESS STUDIES,ACC...

24. College Application Details :


Pref. College Degree Subject/Group
1 [955] I.P. COLLEGE, CAMPUS 2, BULANDSHAHR B.B.A Business Administr...

Printed: Sunday, August 7, 2022 09:55 PM Page: 1/2


CHAUDHARY CHARAN SINGH UNIVERSITY, MEERUT
Under-Graduate (UG) Admission Registration Form
SESSION 2022 - 2023
Registration # 22G0085348 Reg. Date : 6 August, 2022 05:51 PM

25. 10th Marksheet #: 1704875 26. 10th Roll No. : 21136842

27. 12th T/c Number: 28. 10th Passing Year: 2020


29. AADHAAR No.: 629380495182 30. AADHAAR Enroll # :
31. Payment Details: Paid Rs.115.00 on 7/8/2022 PayU# 15644934834 Bank Ref: UPI - 221916899401
32. Other Qualifications :

L
NA
NOTE: Mark the number of documents ( Photocopy/Xerox) attached by the Candidate during form submission to the college

Xth Marksheet Xth Certificate


XIIth Marksheet Last Exam Passed Marksheet
Recent Passport Sized Photograph Scanned Signature
Domicile (for other state) Certificate for Kashmiri Resident
FI

Certificate for Horz./Reservation Category Certificate for Vert./Caste Category

Declaration

I declare that I have never been convicted for any criminal act and that there is no case pending against me in
the court of law. I also declare that I have never been caught using Unfair Means or any Disciplinary action
has been taken against me. If I was charged for using Unfair Means, the punitive duration is over and charges
have been cleared.

I have read carefully and have understood all rules as mentioned in the University Rules and Admission
Brochure.

Furthermore I also declare that if my application is found to contain incorrect/false information regarding my
Name, Birth Date, Gender, Religion, Domicile, Weightage, Caste, Horizontal Reservation, Marks obtained or
any other field, my application is liable to get cancelled, and I will have no objection in getting disqualified for
admission to the concerned course/college.

Signature of Parent/Guardian Signature of Candidate


Date: Date:

Printed: Sunday, August 7, 2022 09:55 PM Page: 2/2

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