RajivGandhiUniversityofKnowledgeTechnologiesBasar

ApplicationforAdmissioninto6YearIntegratedB.TechProgram2016
PersonalandFamilyDetails
ApplicaitonID: RGU2016TS0009370
FullName: MURIKIPUDIRAJESH
Father'sName: MSRINIVAS
Gender: Male
Mobile: 8179739231
LocalArea: Local
District: Hyderabad
MotherTongue: Telugu

HallTicketNo: 1603104050
Dateofbirth: 20010322
Mother'sName: MPADMAVATHI
Category: BCB
Email: sksri42@gmail.com
State: Telangana
Mandal: Musheerabad
Religion: IndianHindu

AreyouaPhysically No
Handicapped(PH)
Person:

Reservation No
under
CAP(Childernof
Armed
Personnel):

Reservationunder No
NCC?:

Reservation No
underSports:

Address:
12111210,
boudhanagar
warasiguda,
secunderabad,
telangana,
500061

XStandardSchoolDetails
WhetherSSCor Yes
equivalentexam,
attemptedfirsttime?
SchoolManagement: Private
Xclassdistrict: Hyderabad

Board: TSSSC

SchoolType: Private
SchoolName: sreebhalajihigh
school

DECLARATION
Iherebydeclarethatalltheparticularsfurnishedinthisapplicationaretrue,correctandcompletetothebestofmyknowledge
andbelief.Intheeventofanyinformationbeingfoundfalseorincorrectorineligibility,actioncanbeinitiatedagainstmebythe
RGUKTBasar.
Sd/
MURIKIPUDIRAJESH
20160516

ListofCertificatestobeenclosed:
Acopyofthisprintoutalongwiththefollowingattachments:
APOnlinepaymentreceipt/Onlinepaymentreceipt
CopyofXclassHallTicketandMemo
CopyofStudyCertificatesfromIVtoXclassandResidencecertificate
CopyofIncomecertificate(ifeligible)
CopyofCastereservationcertificate(ifeligible)
CopyofSpecialCategories(PH/CAP/NCC/Sports)certificates(ifeligible)

Shouldbepostedto:
TheDirecotr,
RGUKT,Basar,
MudholeMandal,
AdilabadDistrict,
TelanganaState504107