8/22/14 Applicant Details

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Application Form
Stream Applied
Stream Name: SX
Personal Details
Name of Applicant: NISHCHAL GUPTA
Date Of Birth: 09/09/1997
Category: General
Person with disability: No
Nationality: Indian
Gender: Male
Address Line 1: PLOT NO. B-41, FLAT NO. G-2,
Address Line 2: PARIWAR APPTS
Address Line 3: SHALIMAR GARDEN
Address Line 4: EXTENSION - 2, SAHIBABAD
District: GHAZIABAD
State: UTTAR PRADESH
Pincode: 201005
Mobile No: 9810592992
Email ID: dkgupta66@gmail.com
Mailing Address State Code: 29
Exam Board: 01 CBSE
Aggregate % of Marks in all Science subjects
and Mathematics: 100
How did you come to know about the KVPY
Program? :
Friends/Relatives
In the academic year 2014-15, I have
joined:
01/04/2014
Name: VIVEKANAND SCHOOL
Address : D BLOCK ANAND VIHAR
City: DELHI
State: Delhi
Pincode: 110092
Preferred Exam Language: English
Preferred Exam Mode: Offline/OMR based
8/22/14 Applicant Details
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Version 8.00.01
City for writing the Aptitude Test: Delhi
Declaration
I declare that the information provided above are true to the best of my knowledge and belief. I understand that if it is found that I do not meet the eligibility
norms at any point of time I may face disqualification from the KVPY program.