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    National Entrance Screening Test - 2023

    Uploaded by

    rpriyanshu965

    Copyright:

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

    National Entrance Screening Test - 2023

    Uploaded by

    rpriyanshu965
    11 views2 pages

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

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

    National Entrance Screening Test - 2023

    Uploaded by

    rpriyanshu965

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    5/13/23, 9:03 PM National Entrance Screening Test - 2023

    Personal Details

    Registration Numbe Applicant Name :


    r SHUBHAM ARYAN
    N23046368

    Photo
    Date of Birth (DD-M Gender X/10th Roll No./Regi
    M-YYYY) Male stration No. :
    08/Jun/2005 7320459
    Father’s/Mother’s/S Category:
    pouse Name SC
    Subhash paswan
    Are you in Supernu Person with Disabili
    merary: J & K Catego ty? :
    ry? : No
    No

    Details of guardian

    Name of the guardia The guardian is your Guardian's Mobile N


    n father o
    Subhash paswan 9771487630

    Correspondence Address Details

    Address Line 1
    D.S COLONY Q.R NO.555/B HIRAPUR NEAR JHARKHAND MAI
    City Name State District
    DHANBAD JHARKHAND Dhanbad
    Pincode Mobile No Email ID
    826001 9508766370 aryanshubham89@g
    mail.com
    Alternate Mobile Nu Is Permanent Addre
    mber ss same as Present a
    8271970052 ddress?
    Yes

    Permanent Address

    Address Line 1
    D.S COLONY Q.R NO.555/B HIRAPUR NEAR JHARKHAND MAI
    City Name State District
    DHANBAD JHARKHAND Dhanbad
    Pincode Mobile No Email ID
    826001 9508766370

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    5/13/23, 9:03 PM National Entrance Screening Test - 2023

    aryanshubham89@g
    mail.com
    Alternate Mobile Nu
    mber
    8271970052

    10th / Equivalent Details

    Name of the Board/ Year Of Passing Percentage of Marks


    Council 2021 73.6
    ICSE

    12th / Equivalent Details

    Name of the Board/ Year Of Passing


    Council 2023 (results awaited)
    ICSE

    Test Center Selection Details:

    Preference State 1 Preference City 1 Preference State 2


    Jharkhand Dhanbad Jharkhand
    Preference City 2 Preference State 3 Preference City 3
    Bokaro Steel City Bihar Patna
    Preference State 4 Preference City 4 Preference State 5
    Jharkhand Ranchi West Bengal
    Preference City 5
    Asansol

    Payment Details:

    Amount Payment Mode Payment Status


    600 online PaymentSuccess
    Payment Transactio Order ID
    n ID N2304636820230513
    CPACSZGNT5 210208517

    Document Upload Details

    Signature

    Declaration Details

    Declaration:
    I hereby declare that I have carefully read the Prospectus and the Non-Disclosur
    e agreement in the prospectus. All the particulars stated in this application form
    are true and correct to the best of my knowledge and belief. If any of these infor
    mation provided is found false/ incorrect, I shall abide by the actions and decisio
    ns taken by the "National Institute of Science Education and Research".

    https://g21.digialm.com/EForms/SBINewAfterPaymentAction.do?81882ZZ1834ZZonlineSBI 2/2

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