ONLINE

FormNo:5567290

Basic Details
Name:

AyushiBhargava

Program&Campus
Option1:* B.Sc.(H)FSNoida
Option2: B.Sc.(H)MBTNoida

AdmissionCategory:
Category:

NS

GEN

DateOfBirth

16/03/1995

HostelAccommodation
Mobile
Landline
Email*

No

+91 9045236162
+91 05738 244283
ankitbhargava06@gmail.com

Payment Details
Yourpaymenttransactionnumber:201508210826002
Yourpaymenttransactiondate:21Aug2015
Ifyouhaveanyquestions,chatwithourCounsellorsatwww.amity.edu(http://www.amity.edu/),oremailtoadmissions@amity.edu
(mailto:admissions@amity.edu),
orcallusat01202445252/4713600

Personal Details
PhysicalStandard
Gender

Female

Nationality*
Passport

Height: 5Ft. 5Inches. Weight:65Kg.

Indian

No

Correspondence Address

Permanent Address
sameascorrespondenceaddress

Forallcommunicationrelatedtoyouradmission.

1420,AhirPada,

1420,AhirPada,

BurjUsmanKhan,

BurjUsmanKhan,

Khurja,UttarPradesh203131

Khurja,UttarPradesh203131

India

India

Doyousufferfromanychronicailment

No

Haveyoueverbeensuspended,dismissedorputonacademicprobationorwarningatanyschoolor
college?
No

Family Information
Father Details
Name

TrilokiNathBhargava

Email

Age

50

Mobile

+91 9411233337

Qualification

SchoolLevel

Profession

Organisation

BhargavaProvisionStore

Designation

Business
SelfEmployed

Mother Details
Name*

AnitaBhargava

Age

44

Mobile

Email

+91 9411979311

Qualification

Bachelors

Profession

Organisation

None

Designation

Family at Amity Any of your associated with Amity

FamilyMember:

No

HouseWife
None

Education Details
Itismandatorytofillalldetailsofeducationalqualification(asapplicable)fromclassXonwardstilllastcompletedsemester/year.Ifthe
systemofmarkingofyourschool/collegeisongradingpattern,convertgradeintomarksasapplicableandfillintherespectivecolumns.
Inabsenceofcompleteinformation,formwillberejected.

Class X
Board

CBSE

BoardRollNo
PassingYear

5134680
2011

AggregatePercentage

8.80

Class XII
Board

CBSE

PassingYear

2013

Mediumofinstruction
SchoolName
City

English

MaharajaAgrasenPublicSchool

Khurja

Pin/ZipCode

203131

XIIBoardName
BoardRollNo

CENTRALBOARDOFSECONDARYEDUCATION
5635881

XIIResultsDeclared
MarkType

Yes

Marks

ClassXIIBoardResultDetails(ProvidedetailsofallsubjectsasinclassXIImarksheet)
SNo

SubjectName

Marks

Maximum

obtained

Marks

BIOLOGY

70

100

CHEMISTRY

74

100

PHYSICS

52

100

ENGLISHCORE

75

100

PHYSICALEDUCATION

74

100

PAINTING

87

100

Other Information
Awards / Achievements Name
(ifany,latesttwo)Proofwillbeverifiedonthedayofselection)
Sno.

NameoftheAwards/Achievements

Receivedwhen

1
2

Employment
WorkExperience

No

Previously Applied
HaveyoupreviouslyappliedtoAmity?

No

Forwhat