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Jee Adv Form

This document is a registration acknowledgment for the Joint Entrance Examination (Advanced) 2025 for candidate H Harini, who is eligible to appear based on her JEE (Main) scores. It includes personal details, academic information, examination city preferences, and payment confirmation. The candidate has declared the accuracy of the information provided and acknowledges the consequences of any discrepancies.

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hariprasad j
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0% found this document useful (0 votes)
29 views1 page

Jee Adv Form

This document is a registration acknowledgment for the Joint Entrance Examination (Advanced) 2025 for candidate H Harini, who is eligible to appear based on her JEE (Main) scores. It includes personal details, academic information, examination city preferences, and payment confirmation. The candidate has declared the accuracy of the information provided and acknowledges the consequences of any discrepancies.

Uploaded by

hariprasad j
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 (Advanced) 2025

Indian Institutes of Technology


Registration Acknowledgement

Registration No. K42121003928


Candidate Details
JEE (Main) Application number 250310040978 Date of Birth 17/06/2007
Candidate's Name H HARINI Category General
Mother's Name PREMAVATHI H Person with Disability (PwD) as per No
JEE(Main)
Father's Name HARIPRASAD J Nationality Status INDIAN
Complete Mailing Address
Address 136/6 2ND CROSS SBMCOLONY
Country India
State TAMIL NADU District KRISHNAGIRI
Locality OPP TVS NAGAR Mobile Number 91 - 848****069
Whatsapp Mobile Number 91 - 848****069 City/Town/Village HOSUR
Email Address har*************[email protected] Pin Code / Postal Code 635110
Alternate Mobile number 91 - 948****785 Land Line Number 9488404785
Academic details of Class XII (or equivalent) examination
Year of Passing or Appearing 2025
School Board CENTRAL BOARD OF SECONDARY EDUCATION
Roll Number --
Name of the School / College SRI VIJAY VIDYASHRAM BAGALUR HOSUR KRISHNAGIRI TAMILNADU
Address of the School / College SRI VIJAY VIDYASHRAM BAGALUR HOSUR KRISHNAGIRI TAMILNADU
JEE (Main) Paper 1 Score
Physics: 85.8954344 Chemistry: 98.2421066 Maths: 85.5019594 Total: 94.9596967
Remarks : Eligible for JEE (Advanced) 2025.
Furnished Information for JEE (Advanced) 2025
Do you have disability and having No
difficulty in writing
Need scribe/reader No Do you want to avail compensatory time No
as of GoI guidelines/ memorandum?
Class XIIth (or equivalent)/ Qualifying India Year of first appearance in Class XII 2025
Exam (QE) Passed From Exam
Year of first attempt in JEE (Advanced) 2025 Color Blindness No
One Eyed Vision No Eligible for DS Seats No
Examination City for JEE (Advanced) 2025
1st Choice of Exam City TAMILNADU-SALEM 2nd Choice of Exam City TAMILNADU-VELLORE
3rd Choice of Exam City KARNATAKA-BENGALURU 4th Choice of Exam City KARNATAKA-TUMAKURU (TUMKUR)
5th Choice of Exam City KARNATAKA-MYSURU (MYSORE) 6th Choice of Exam City TAMILNADU-NAMAKKAL
7th Choice of Exam City KARNATAKA-HASSAN 8th Choice of Exam City TAMILNADU-TIRUCHIRAPPALLI
9th Choice of Exam City TAMILNADU-COIMBATORE 10th Choice of Exam City TAMILNADU-CHENNAI
Payment Details
Payment Provider BILLDESK (EPG) Transaction ID BIC50370IY9RB7
Registration Fee INR 1600 Date of Transaction 2025/04/23T11:42:11
DECLARATION
I hereby declare that all the particulars stated in this Registration Form are true to the best of my knowledge and belief. I understand that, if any of the information provided by me
is found to be false / incorrect at any later time, my candidature will be cancelled and I shall be debarred from writing JEE (Advanced) 2025. I understand that an exam city not
mentioned in my preferred choices may be allotted to me under exceptional circumstances and any request for the change of the exam city will NOT be entertained. In case, it is
found that I am ineligible to appear for JEE (Advanced) 2025 at any stage, I understand that my candidature will be cancelled and registration fee will be forfeited. I understand
that the data from JEE (Advanced) 2025 including personal details may be shared with other Government-funded institutes.
Certificates uploaded
Class-X or Birth Certificate Uploaded

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