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    Assam State Higher Education Admission Portal Admission Session 2024-2025 Registration Number: 240053437 Form Number: 84005005

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    Assam State Higher Education Admission Portal Admission Session 2024-2025 Registration Number: 240053437 Form Number: 84005005

    Uploaded by

    agendamalhotra
    9 views2 pages
    Hello Tuhin

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    84005005_1719038924

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    9 views2 pages

    Assam State Higher Education Admission Portal Admission Session 2024-2025 Registration Number: 240053437 Form Number: 84005005

    Uploaded by

    agendamalhotra
    Hello Tuhin

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    Assam State Higher Education Admission Portal

    Admission Session 2024-2025


    Registration Number: 240053437
    Form Number: 84005005

    Programme : Bachelor of Science(Faculty of Earth Sciences and Energy)


    College : 406: Gargaon College
    University: 33: Dibrugarh University
    Application Status : Submitted
    Admission Scheme: 1 Major 1 Minor
    Course(s) Selected:
    Subject I: Geology
    Subject II: Geography
    Personal Details
    Full Name of the Applicant : AMLANJYOTI RAJKONWAR Gender : Male
    Social Category : OBC / MOBC
    Date of Birth: 6 November 2005
    Certificate Number 02042024-001-10048020
    Age as on: July 1, 2023: 17 Years 7 Month 26 Days
    Certificate Issuing Date 2024-04-02
    Blood Group: O+ Religion : Hinduism
    Nationality Indian
    Do you have domicile of Assam? Yes
    Registered Email : [email protected] Registered Mobile Number: 9864226863
    Alternate Email : Not Provided Alternate Mobile : 9954363500
    Permanent Address: Lakwa Lakhimipam Gaon, Rajgarh Road, CHARAIDEO, Correspondence Address : Lakwa Lakhimipam Gaon,
    Assam -785698, India Rajgarh Road, CHARAIDEO, Assam -785698, India
    ID Proof : PAN Card ID Proof No : FMGPR0622N

    University Registration details (if applicable)


    Have you enrolled in University/Autonomous College before? : No Registration Number: Not Provided
    University Name of School/Department/Faculty/College: Not Provided Programme registered in: Not Provided
    Family Details
    Mother's Name : KABITA RAJKONWAR Father's Name : NILAMONI RAJKONWAR
    Mother's Qualification : Non Graduate Father's Qualification : Graduation
    Mother's Occupation : Un Employed Father's Occupation : Agriculture
    Mother's Mobile Number : 9954363500 Father Mobile Number : 8473076272
    Mother's Office Address : Not Provided Father's Office Address : Not Provided
    Father your Guardian : Yes
    Emergency Contact Number : 9954363500
    Combined Family Income : Not Applicable
    Other Category/Quota
    Person with Benchmark Disabilities (PwBD) Category : Not Applicable
    Are you an Ex-Service man? : No
    Are you dependent of Freedom Fighter? : No
    Extra Curricular Activity :
    Sports Quota No
    Do you have any illness which requires continuous or emergency medical attention? No
    Do you belong Urban/Rural/Semi-Urban/Metropolitan Area? Semi-Urban
    Are you Son/Daughter of present employee of university/college ? No
    Do you belong to Fringe Village of Assam? No
    Do you belong to Moran Community of Assam? No
    Do you have Migration Certificate? No
    Do you have transfer certificate from your School/College? No
    a) Candidates having NCC 'B' 'C' certificate No
    b) Have you attended any special camp under the National Service Scheme No
    Language Proficiency (Reading/Writing/Speaking)
    Hindi Speaking
    English Reading Writing Speaking
    Assamese Speaking
    Qualification Details - X or Equivalent
    Class X Year of Passing 2022
    Class X Percentage (If your mark is in CGPA, please convert to
    equivalent percentage as per your CGPA score and CGPA 83.50
    Scale)
    Class X Name of the Institution/School MODEL ENGLISH SCHOOL
    Class X Board/University SECONDARY EDUCATION BOARD of ASSAM (SEBA)
    ASSAMESE.ENGLISH,GENERAL MATHEMATICS, GENERAL
    X Subject Combination
    SCIENCE,SOCIAL SCIENCE,COMPUTER SCIENCE
    Class X Division First Division
    Qualification Details - XII or Equivalent
    Class XII Qualification Status Passed
    XII Year of Passing Final Examination 2024
    Class XII Stream Science
    Class XII Percentage 70.60
    Class XII Division First Division
    Class XII Name of the Institution/School ARYBHATTA ACADAMY SENIOR SECONDARY SCHOOL
    Class XII Board/University ASSAM HIGHER SECONDARY EDUCATION COUNCIL
    Class XII Subject Combination ASSAMESE,ENGLISH,COMPUTER SCIENCE,CHEMISTRY,PHYSICS,MATHS
    Class XII Roll Number 0876 20042
    XII Score Card
    Name of the Subject Total Marks Obtained Marks
    ENGLISH 100.00 77.00
    ALTERNATIVE ENGLISH 100.00 75.00
    COMPUTER SCIENCE (NEW) 100.00 90.00
    CHEMISTRY 100.00 59.00
    PHYSICS 100.00 52.00

    Uploads
    Document Upload Status
    Photo Uploaded
    Signature Uploaded
    OBC Category Certificate Uploaded
    ID Proof Document Uploaded
    Proof of permanent residence of Assam (PRC, Voter ID, Aadhar, Caste Certificate, Birth Certificate, School ID, or any
    Uploaded
    other certificate issue by competent authority of Govt of Assam)
    Class X (Scan your marksheet in a single file and upload)] Uploaded
    Class XII (Scan your marksheet in a single file and upload) Uploaded
    "I do hereby declare that all the statement made in the application are true, complete and correct to the best of my knowledge and belief. I am duly
    aware that in the event of any particulars or information furnished by me is found to be false/incorrect/incomplete or if i am found indulging in some
    unlawful act at any time during the course period, my candidature is liable to be summarily rejected/cancelled."Additionally undertaking for students
    whose results are awaited: "I, having been permitted to be provisionally admitted to University hereby undertake to produce the proof of having
    successfully qualified in the final qualifying examination with requisite percentage of marks if failing, I shall forthwith vacate the seat and shall have no
    claim for refund of fees already paid."

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