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    UPSEE2017 ConfirmationPage PDF

    Uploaded by

    Bheeshm Singh
    This document is a confirmation page for an application to the Uttar Pradesh State Entrance Examination 2017. It provides personal details of the applicant named Jay Vardhan, along with educational details, courses applied for, payment details, and a declaration signed by the candidate. The applicant is seeking admission to the first year of B.Tech and has applied to appear for Paper 1.

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

    UPSEE2017 ConfirmationPage PDF

    Uploaded by

    Bheeshm Singh
    38 views1 page
    This document is a confirmation page for an application to the Uttar Pradesh State Entrance Examination 2017. It provides personal details of the applicant named Jay Vardhan, along with educational details, courses applied for, payment details, and a declaration signed by the candidate. The applicant is seeking admission to the first year of B.Tech and has applied to appear for Paper 1.

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    UPSEE2017_ConfirmationPage (4).pdf

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    This document is a confirmation page for an application to the Uttar Pradesh State Entrance Examination 2017. It provides personal details of the applicant named Jay Vardhan, along with educational details, courses applied for, payment details, and a declaration signed by the candidate. The applicant is seeking admission to the first year of B.Tech and has applied to appear for Paper 1.

    Copyright:

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

    UPSEE2017 ConfirmationPage PDF

    Uploaded by

    Bheeshm Singh
    This document is a confirmation page for an application to the Uttar Pradesh State Entrance Examination 2017. It provides personal details of the applicant named Jay Vardhan, along with educational details, courses applied for, payment details, and a declaration signed by the candidate. The applicant is seeking admission to the first year of B.Tech and has applied to appear for Paper 1.

    Copyright:

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

    Uttar Pradesh State Entrance Examination - 2017

    Dr. A P J Abdul Kalam Technical University Uttar Pradesh, Lucknow


    Confirmation Page

    Application No. 4099795 -


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

    Personal Details
    Name: JAY VARDHAN Date of Birth: 17-01-1999
    Mother's Name: MANJU KUMARI Category: UPGD
    Father's Name: VINOD KUMAR Gender: Male
    Nationality: Indian Rural weightage claimed: No
    Aadhaar Number : 950087874130 Domicile: UTTAR PRADESH
    Qualifying examination passed/appeared OTHER THAN UTTAR PRADESH Subcategory: Armed Forces
    from college situated in:

    Course Apply Details


    Applying For: UG
    Qualifying Examination: INTERMEDIATE
    1st Choice of Exam Centre: Varanasi(OMR Based Exam ( For Paper 1, 2, 3 2nd Choice of Exam Centre: Allahabad(OMR Based Exam ( For Paper 1, 2, 3
    & 4 only) & Computer Based Test (For Paper 5, & 4 only) & Computer Based Test (For Paper 5,
    6,7 &8 only)) 6,7 &8 only))
    3rd Choice of Exam Centre: Lucknow(OMR Based Exam ( For Paper 1, 2, 3
    & 4 only) & Computer Based Test (For Paper 5,
    6,7 &8 only))

    Educational Details
    Qualification Pass Course/Stream Name Board/University Name Year Of Marks (%) Roll No. Institute Name & Address Pincode
    Status Passing
    INTERMEDIATE Appeari INTERMEDIATE CBSE i (CBSE international) 2017 4635887 sri chaitanya iit acadmy 521104
    ng vijaywada

    Subject in 10+2
    Chemistry (Theory + Practical) , Computer Science , English , Mathematics , Physics (Theory + Practical)

    Seeking Admission & Courses Applied For


    Seeking Admission For: FIRST YEAR
    Courses Applied For 1st Year Admission: B.Tech.
    Paper(S) In Which You Wish To Appear : Paper 1

    Communication Details
    Address: L - 10/21, GANESH PURI COLONY City/Town/Village: SUSUWAHI
    District: VARANASI State: UTTAR PRADESH
    Pin Code: 221011 Email Address: [email protected]
    Mobile Number: 9453494056 Land Line Number: --
    Do you want to share your personal Information ?: No

    Fee Payment Details


    Payment Mode: Online Payment Transaction ID: HHMP5145945214
    Exam Fee: 1200 /- Date of Transaction: 27-02-2017 12:38:59
    Fee Submitted On: 27/02/2017
    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 Board
    procedures. I shall abide by the terms and conditions thereon.

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