Registration Date :: 17/08/2013 Form Print Date :: Saturday, August 17, 2013 7:10 PM

CHAUDHARY DEVI LAL UNIVERSITY, SIRSA

Online Registration & Counseling for B.Ed. (Regular) Course (2013-14) Online Application Form Registration No : Applied For : Candidate Name: Fathers Name: Mothers Name: Date Of Birth: Sex: Caste Category: PWD (Person With Disabilities): Defence Person / Dependent: Freedom Fighter(FFC): Category: 429296 Science / Arts with Maths GAUTAM BUDH SHARMA HARI PARKASH SARSWATI 02/10/1993 Male GENERAL No No No Haryana General Category [85% seats reservation].
429296

You are Bonafide Residents of Haryana.

Mobile Number: Phone Number: E-Mail ID: Address for correspondence: (a). HouseNo / Locality: (b). Village / Town / City: (c). District: (d). State: (e). Pincode: Payment Mode:

09996964546 0 gautamgalib@gmail.com 380 MAURI BHIWANI Haryana 127022 PNB Bank Challan - Rs.1000 + Rs. 6 (Bank Charges) = Rs.1006

Qualifying Exam. Details:

Name of the Examination 10th (Secondary) Name of the University / Board with State HBSE Roll No. Regd. No. Year / Session 2008
Marks/CGPA obtained Total Marks/ CGPA Scale

%age 83.5

2207353630 aj-023344

9.8

10

12th (Sr. Secondary)

HBSE

3209175391 ak-034428 2010

5.6

10

59

B.A.

MONAD UNIVERSITY

4120002

mu1013ba 2013 2250002 0

2983

4100

72.756

Select PG Stream

Bank Challan

(Bank Copy)

Bank Challan

University Copy

Bank Challan

Candidate Copy

Coordinator B.Ed Admissions 2013-14,

Coordinator B.Ed Admissions 2013-14,

Chaudhary Devi Lal University, Sirsa MENU - FCMBR INSTITUTE CODE - CDLU COLLECTION CODE - BED
Course: B.Ed. 2013

Chaudhary Devi Lal University, Sirsa MENU - FCMBR INSTITUTE CODE - CDLU COLLECTION CODE - BED
Course: B.Ed. 2013

Coordinator B.Ed Admissions 2013-14,

Chaudhary Devi Lal University, Sirsa MENU - FCMBR INSTITUTE CODE - CDLU COLLECTION CODE - BED
Course: B.Ed. 2013

Application No: Candidate Name: Father's Name:

429296
GAUTAM BUDH SHARMA HARI PARKASH

Application No: Candidate Name: Father's Name: Mobile No:

429296
GAUTAM BUDH SHARMA HARI PARKASH

Application No: Candidate Name: Father's Name: Mobile No:

429296
GAUTAM BUDH SHARMA HARI PARKASH

Mobile No ::

09996964546 1000 6 1006

09996964546 1000 6 1006

09996964546 1000 6 1006

Amount of fee (In Figure ): Bank Charges Total Amount (In Words

Amount of fee (In Figure ): Bank Charges Total Amount (In Words

Amount of fee (In Figure ): Bank Charges Total Amount (In Words

ONE THOUSAND SIX RUPEES ONLY Deposited By: Detail of the Cash: 1000 X 500 X 100 X 50 X 20 X 10X Coins Total (To be filled in By the Bank) Transaction ID: .................. Branch Code: Deposit Date:

ONE THOUSAND SIX RUPEES ONLY Deposited By: Detail of the Cash: 1000 X 500 X 100 X 50 X 20 X 10X Coins Total (To be filled in By the Bank) Transaction ID: .................. Branch Code: Deposit Date:

ONE THOUSAND SIX RUPEES ONLY Deposited By: Detail of the Cash: 1000 X 500 X 100 X 50 X 20 X 10X Coins Total (To be filled in By the Bank) Transaction ID: .................. Branch Code: Deposit Date:

Amount Received: ____________________

Amount Received: _____________________

Amount Received: ____________________

Stamp Of The Bank

Stamp Of The Bank

Stamp Of The Bank

Registration Date :: 17/08/2013 Challan Print Date :: Saturday, August 17, 2013 7:10 PM

Registration Date :: 17/08/2013 Challan Print Date :: Saturday, August 17, 2013 7:10 PM

Registration Date :: 17/08/2013 Challan Print Date :: Saturday, August 17, 2013 7:10 PM