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    JEE (Main) AcknowledgementPage

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    Anshaj Shukla
    This document is an acknowledgement page for Sahaj Shukla's application to the Joint Entrance Examination (Main) - 2018. It provides her personal details like name, date of birth, category, academic details from class 10th and 12th, contact information, and payment details. The page confirms receipt of her application and 500 rupee examination fee paid via HDFC Bank electronic payment gateway. Candidates are requested to retain this printout for future reference.

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

    JEE (Main) AcknowledgementPage

    Uploaded by

    Anshaj Shukla
    60 views1 page
    This document is an acknowledgement page for Sahaj Shukla's application to the Joint Entrance Examination (Main) - 2018. It provides her personal details like name, date of birth, category, academic details from class 10th and 12th, contact information, and payment details. The page confirms receipt of her application and 500 rupee examination fee paid via HDFC Bank electronic payment gateway. Candidates are requested to retain this printout for future reference.

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    JEE(Main)_AcknowledgementPage

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    This document is an acknowledgement page for Sahaj Shukla's application to the Joint Entrance Examination (Main) - 2018. It provides her personal details like name, date of birth, category, academic details from class 10th and 12th, contact information, and payment details. The page confirms receipt of her application and 500 rupee examination fee paid via HDFC Bank electronic payment gateway. Candidates are requested to retain this printout for future reference.

    Copyright:

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

    JEE (Main) AcknowledgementPage

    Uploaded by

    Anshaj Shukla
    This document is an acknowledgement page for Sahaj Shukla's application to the Joint Entrance Examination (Main) - 2018. It provides her personal details like name, date of birth, category, academic details from class 10th and 12th, contact information, and payment details. The page confirms receipt of her application and 500 rupee examination fee paid via HDFC Bank electronic payment gateway. Candidates are requested to retain this printout for future reference.

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    © All Rights Reserved
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    Joint Entrance Examination (Main) - 2018

    CENTRAL BOARD OF SECONDARY EDUCATION


    ACKNOWLEDGEMENT PAGE

    Application No. 80982660


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

    Personal Details
    Name: SAHAJ SHUKLA Date of Birth: 02/07/1999
    Mother's Name: AYOGIKA SHUKLA Category GENERAL
    Caste Name NA Father's Name: RAJESH KUMAR SHUKLA
    Person with Disability(PwD): NO State of Eligibility: UTTAR PRADESH
    Percentage of Disability: -- Gender: FEMALE
    Are you Diabetic :: NO Nationality: INDIAN
    Place of Residence: URBAN You need scribe/reader ?: NO

    Examination Details
    Applying For: JEE(Main) Paper - 1 (B.E./B.Tech.) Only
    Mode of Examination: PEN AND PAPER BASED EXAMINATION Question Paper Medium: ENGLISH
    1st Choice of Exam Centre: ROORKEE 2nd Choice of Exam Centre: DELHI
    3rd Choice of Exam Centre: KANPUR 4th Choice of Exam Centre: LUCKNOW

    Academic Details
    Year of passing class 10th: 2015 Place of 12th class schooling: CITY
    Year of Passing or Appearing class 12th/Qualifying Exam: 2017 Type of Institution of Class 12th/Qualifying Exam: PRIVATE
    School Board of class 12th/Qualifying Exam: CENTRAL BOARD OF SECONDARY EDUCATION
    Name of the Qualifying Examination passed / appearing: The final examination of the 10+2 system, conducted by any recognized central/ state Board, such as Central
    Board of Secondary Education, New Delhi; Council for the Indian School Certificate Examinations, New Delhi;
    etc.
    Percentage of Marks in Class 12th/Qualifying Exam: 71.60 Roll No. of Class 12th/Qualifying Exam: 5888847
    Appeared/Appearing for Improvement of Class YES Mode of preperation: SELF STUDY
    12th/Qualifying Exam:
    Roll Number of Class 12th/Qualifying Examination of
    Improvement Examination:
    Name and Address of the School/College from where GODWIN PUBLIC SCHOOL FAZALPUR MEERUT UP
    passed/appearing:

    Candidate's Mailing Address


    Country: India State: UTTAR PRADESH
    District: MEERUT Address: B-16/1 NAND VIHAR
    Locality: ROHTA ROAD City/Town/Village: MEERUT
    Pin Code: 250002 Email Address: sah*******@rediffmail.com
    Mobile Number: 902****530

    Guardian Details
    Qualification Occupation Annual Income
    Father's/Guardian's: GRADUATE SELF EMPLOYMENT RS. 200001 - 300000
    Mother's: POST GRADUATE TEACHING / RESEARCH RS. 100001 -200000

    Payment Details
    Provider Name: HDFC Bank Payment Gateway Payment Mode: Electronic Payment Gateway
    Fee Type: Examination Fee Transaction Amount: 500 /-
    Transaction ID: LHMP5921133538 Date of Transaction: 28-12-2017 21:23:58
    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 JEE procedures for both
    JEE(Main) and JEE(Advanced) - 2018. I shall abide by the terms and conditions thereon.

    Images Uploaded by Candidate


    Candidate Photograph Candidate Signature Parent/Guardian Signature

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