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    Candidate's Details: Type of Disability

    Uploaded by

    Chethan Chethan
    1. This document contains the application details of candidate GAYATHRI N for admission to a Day Engineering College. 2. The key details provided include the candidate's name, father's name, date of birth, gender, contact information, annual family income, religion, caste, eligibility details and course details. 3. The document also includes information about the candidate's educational qualifications, marks obtained in diploma examinations, reservation category claimed and declaration signed by the candidate.

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    Candidate's Details: Type of Disability

    Uploaded by

    Chethan Chethan
    38 views2 pages
    1. This document contains the application details of candidate GAYATHRI N for admission to a Day Engineering College. 2. The key details provided include the candidate's name, father's name, date of birth, gender, contact information, annual family income, religion, caste, eligibility details and course details. 3. The document also includes information about the candidate's educational qualifications, marks obtained in diploma examinations, reservation category claimed and declaration signed by the candidate.

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    Application_2021512647_05112021_145821

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    1. This document contains the application details of candidate GAYATHRI N for admission to a Day Engineering College. 2. The key details provided include the candidate's name, father's name, date of birth, gender, contact information, annual family income, religion, caste, eligibility details and course details. 3. The document also includes information about the candidate's educational qualifications, marks obtained in diploma examinations, reservation category claimed and declaration signed by the candidate.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    38 views2 pages

    Candidate's Details: Type of Disability

    Uploaded by

    Chethan Chethan
    1. This document contains the application details of candidate GAYATHRI N for admission to a Day Engineering College. 2. The key details provided include the candidate's name, father's name, date of birth, gender, contact information, annual family income, religion, caste, eligibility details and course details. 3. The document also includes information about the candidate's educational qualifications, marks obtained in diploma examinations, reservation category claimed and declaration signed by the candidate.

    Copyright:

    © All Rights Reserved
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    Download as pdf or txt
    of 2

    Candidate's Details

    Application Number : 2021512647


    1. Name of the Candidate GAYATHRI N
    [As in SSLC or 10th Std Marks Card] * :
    2. Name of the Mother *: PARVATHAMMA
    3. Name of the Father : NARAYANASWAMY
    4. Date of Birth [As in SSLC or 10th Std Marks Card] * : 02/03/2000
    5. Gender * : Female
    6. Contact Mobile Number * : XXXXXXXXXX
    7. E-Mail-Id : XXXXXXXXXXXX@XXXXXXX
    8. Marital Status Single Spouse Name

    9. Mother Tongue : Kannada Others

    10. Native state *: KARNATAKA 10(a). Native District *: KOLAR

    11. Annual Income of the family from all 15000 12. Religion * : Hindu
    sources * :
    13. Nationality * : Indian Status of Other Religion

    14. Reservation Category *: Category-2A 14(a). Name of th Caste * : BALAJIGA

    14 (b) Income certificate RD Number (RD00-------) RD0038657169080


    14 (c) Caste certificate RD Number starting with (RD0--------)
    15. Eligibility Clause Code * : a

    Course Details
    16. Admission To * : Day Engg College
    17. Exam Place 1 where you wish to appear for Diploma CET 2021 * : KOLAR
    18. Diploma register number * : 131CS18009
    17 A. Exam Place 2 where you wish to appear for Diploma CET 2021 * BENGALURU

    19. Diploma Course Holder in : Computer Science and Engineering


    20.a Dcet Examination Subject*: CS - COMPUTER SCIENCE ENGINEERING

    20. Have you appeared for NATA Exam? No

    Study Information
    21. Total number of completed years of study in Karnataka * : 13
    22. Have you Studied in Rural Area from 1st standard to 10th standard ? No
    23. Have you Studied in Kannada Medium from 1st standard to 10th standard ? No
    24. Are you claiming reservation under Article 371 ( j ) Hyderabad-Karnataka ? No
    24 (a) 371(J) RD Number starting with (RD0--------)

    25. Candidate's Postal Address for Communication


    Full Address * : KESARANAHALLI VILLAGE, ROBETSONPET HOBLI, BANGARPET TALUK, BANGARAPET, KOLAR,
    KARNATAKA - 563162
    26. Special Category :
    Type of Disability

    Study Details
    27. Do you possess a certificate of Diploma or Equivalent Examination ? * No
    28. Are you Awaiting for any Diploma results or Equivalent Examination ? * Yes
    29. Name and Place of the Board / University : BOARD OF TECHNICAL EDUCATION,
    BANGALORE
    Status of other Place of the Board / University :

    30. Name of the College * : SCHOOL OF MINES KGF


    31. College Address : KORAMANDAL KGF
    32. Is your qualification marks card issued in grade points ? * No
    State of Birth KARNATAKA

    Candidate Place of Birth KESARANHALLI

    Printed Date: 05:11:2021 02:58:21


    Year Status of Result Month of Year of Max. Total Marks
    Passing Passing Marks Obtained
    1 Pass APRIL 2019 1200 833
    2 Pass APRIL 2019 1200 1086
    3 RAP SEPTEMBER 2021 0 0

    Declaration

    I declare that the information furnished through online is true and correct to the best of my knowledge and belief. I have read the
    Instructions carefully hosted on the KEA website "Information Bulletin for Filling up of Online Application". In case any of the
    information furnished online by me is found to be false or incorrect, I shall forfeit the claim to be considered or a seat selected
    and allotted by KEA. I am liable for civil and criminal action, that the State Government or the KEA may take against me in this
    regard.

    Signature of the Candidate Left Hand Thumb impression of Date: 09:09:2021 12:50:14
    the Candidate
    Payment Status
    Application Fees: 650 Bank Name: RTGS/NEFT Payments from any Bank
    Account to HDFC bank
    Bank Charges: 0 Bank Ref Number: IBKL210914813314
    Total Amount: 650 Date of Payment: 14-09-2021

    Details of reservation claimed by the candidate


    Clause Code a Name of the Caste BALAJIGA

    Rural No Reservation Category Category-2A

    Kannada No Article 371(J) Hyderabad Karnataka No

    Special Category :

    Type of Disability
    Note (For Evening Engg College): candidate after obtaining the diploma, must have minimum of Two Years Full Time Work experience in
    a registered firm / Company / Industry / Educational and / Government Autonomous Organizations in the relevant field in which admission
    ŝƐƐŽƵŐŚƚďLJŚĞͬƐŚĞĂŶĚŝŶǁŚŝĐŚŚĞͬƐŚĞŚŽůĚƐĂŝƉůŽŵĂĂƐŽŶϭƐƚ^ĞƉƚĞŵďĞƌ͕ϮϬϭϵ͕ŽĨƚŚĞLJĞĂƌŽĨĂĚŵŝƐƐŝŽŶ͘

    Printed Date: 05:11:2021 02:58:21

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