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    Indian Statistical Institute PDF

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    Rebija
    This document contains an application form for admission to the Bachelor of Mathematics (Honours) program at the Indian Statistical Institute. It includes the applicant's personal details, educational qualifications, program and test center preferences, family details, and declaration of truth of the information provided, signed with a date. It also includes a receipt for payment of the application fee of Rs. 1,500.

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    © All Rights Reserved
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    Indian Statistical Institute PDF

    Uploaded by

    Rebija
    68 views4 pages
    This document contains an application form for admission to the Bachelor of Mathematics (Honours) program at the Indian Statistical Institute. It includes the applicant's personal details, educational qualifications, program and test center preferences, family details, and declaration of truth of the information provided, signed with a date. It also includes a receipt for payment of the application fee of Rs. 1,500.

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    INDIAN STATISTICAL INSTITUTE.pdf

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    This document contains an application form for admission to the Bachelor of Mathematics (Honours) program at the Indian Statistical Institute. It includes the applicant's personal details, educational qualifications, program and test center preferences, family details, and declaration of truth of the information provided, signed with a date. It also includes a receipt for payment of the application fee of Rs. 1,500.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    68 views4 pages

    Indian Statistical Institute PDF

    Uploaded by

    Rebija
    This document contains an application form for admission to the Bachelor of Mathematics (Honours) program at the Indian Statistical Institute. It includes the applicant's personal details, educational qualifications, program and test center preferences, family details, and declaration of truth of the information provided, signed with a date. It also includes a receipt for payment of the application fee of Rs. 1,500.

    Copyright:

    © All Rights Reserved
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    of 4

    CHANGE PASSWORD (HTTPS://ISICAL.UCANAPPLY.COM/UNIVER/PUBLIC/CHANGEPASSWORD?

    APP_ID=UELZMDAWMDAZMW==)
    LOGOUT (HTTPS://ISICAL.UCANAPPLY.COM/UNIVER/PUBLIC/USER-LOGOUT?APP_ID=UELZMDAWMDAZMW==)

    Indian Statistical Institute


    203 Barrackpore Trunk Road, Kolkata 700108, India

    APPLICATION FORM FOR ADMISSION TEST


    Application Id: Session 2023-24
    20233382186191
    Payment ID.
    order_LSGBhJ9zha8kfQ

    1. Personal Information:
    Name: JAYDEV TUSHAR CHANDARANA Date of Birth: 23 July, 2005
    Gender: Male Nationality : Indian
    Programme: Bachelor of Mathematics (Honours) Category : GENERAL
    Disability Certificate: No
    Registration No :
    Have you ever joined in the NO
    same programme you are
    applying for:
    Sponsored Candidate: No

    2. Programme Location:
    Preference 1: Bengaluru
    3. Centre Preference:
    Centre Preference 1: Vadodara
    Centre Preference 2: Ahmedabad
    Centre Preference 3: Mumbai
    4. Permanent Address:
    Street/Area: 302, Sun Shilp Apartment, 38/a, Shrinagar Society,, Children's Hospital Lane, Akota, Vadodara
    Post Office: Akota District: Vadodara
    PIN/ZIP code: 390020 State: Gujarat
    Landline No.: India Mobile No: 9825279406

    5. Communication Address:
    Street/Area: 302, Sun Shilp Apartment, 38/a, Shrinagar Society,, Children's Hospital Lane, Akota, Vadodara
    Post Office: Akota District: Vadodara
    PIN/ZIP code: 390020 State: Gujarat
    Landline No.: India Mobile No: 9825279406
    6. Registered Mobile No. 9773085424 7. Registered E-mail [email protected]
    8. Family Details:
    Father's Name: Tushar Chandarana Mother's Name: Heena Chandarana
    Occupation: Business Occupation: Beautician

    9. Local Guardian Details:


    Guardian Name: Piyush Chandarana Relation: Uncle
    Contact: 9408608000

    10. Educational Qualification:

    Name of Examination Year Division/ Name of School/ College Name of Board/ University Total Total % of CGPA
    Grade Marks Secured marks
    GSEB - Gujarat Secondary and Higher
    10th std. 2021 A St. Kabir School 600 557 92.83
    Secondary Education Board
    Gujarat Secondary & Higher
    (10+2)th std. 2023 St. Kabir School Secondary Education Board, Gandhi
    Nagar
    DECLARATION:
    CHANGE PASSWORD (HTTPS://ISICAL.UCANAPPLY.COM/UNIVER/PUBLIC/CHANGEPASSWORD?APP_ID=UELZMDAWMDAZMW==)
    I hereby declare that the information provided above by me is true and accurate to the best of my knowledge and belief.
    LOGOUT (HTTPS://ISICAL.UCANAPPLY.COM/UNIVER/PUBLIC/USER-LOGOUT?APP_ID=UELZMDAWMDAZMW==)
    I consent to the capture of my biometric information by a third party authorized by ISI solely for the purpose of authentication of identity in connection with
    admission to the Indian Statistical Institute in 2023, with the understanding that the data will not be shared with any other organization by the third party and will be
    destroyed after the process is complete.

    Date: 16-03-2023

    Printed on : 16-03-2023 10:03 PM


    (Signature of the candidate)
    CHANGE PASSWORD (HTTPS://ISICAL.UCANAPPLY.COM/UNIVER/PUBLIC/CHANGEPASSWORD?APP_ID=UELZMDAWMDAZMW==)
    LOGOUT (HTTPS://ISICAL.UCANAPPLY.COM/UNIVER/PUBLIC/USER-LOGOUT?APP_ID=UELZMDAWMDAZMW==)
    CHANGE PASSWORD (HTTPS://ISICAL.UCANAPPLY.COM/UNIVER/PUBLIC/CHANGEPASSWORD?APP_ID=UELZMDAWMDAZMW==)
    LOGOUT (HTTPS://ISICAL.UCANAPPLY.COM/UNIVER/PUBLIC/USER-LOGOUT?APP_ID=UELZMDAWMDAZMW==)

    Receipt for Online Payment

    Application No: 20233382186191


    Challan No: order_LSGBhJ9zha8kfQ

    Order Date: 16-03-2023 09:54 PM

    Name: JAYDEV TUSHAR CHANDARANA

    Email ID: [email protected]

    Category: GENERAL

     DEPOSIT DETAILS (INR)

    Sl. No. Particulars Amount (Rs.)

    1 Application Fee Rs.1500

    Amount in Words : Rs. One Thousand Five Hundred only

    This is a computer generated receipt.No signature required


    Non refundable

    Print Cancel (https://isical.ucanapply.com/univer/public/my-application?app_id=UElZMDAwMDAzMw==&sub_id=MTExOTE=)

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