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For Office Use only

Transaction ID: 6639514/BSCB

ALIGARH MUSLIM UNIVERSITY


Session: 2016-2017
Application Form for Admission to

Affix the same


Photograph as you
have uploaded in
the Application Form

B.Sc. (Hons) Boys


Faculty Of Science/Life Science

Bank: CNB, DD/CR No.: 055995, Date: 20-01-2016, Amount: 300

Nationality: INDIAN

Order of Preference of Branches:


__________________________________________________________________________________________________
1. -- 2. -- 3. -- 4. -- 5. -- 6. -- 7. -- 8. -- 9. -- 10. -11. -- 12. -- 13. -- 14. -- 15. -- 16. -- 17. -- 18. -- 19. -- 20. --

Preference for Test Centres:


__________________________________________________________________________________________________
1. ALIGARH 2. LUCKNOW

Personal Details:
__________________________________________________________________________________________________
Name: PUNEET KUMAR
Date of Birth: 01-01-1970
Gender: MALE
Religion: HINDUISM

Father's Name: SHISHU PAL SHARMA


Mother's Name: SHASHI BALA SHARMA

Details of Qualifying Examination:


Status & Special Categories:
__________________________________________________________________________________________________
Status: EXTERNAL
Examination: INTERMEDIATE
Enrolment No.:
Roll No.: RA
Hall: NA
Year of Passing/Appearing: 2016
Special Categories: 1. NA 2. NA 3. NA
Board/Univ.: 526
Marks Obt./Max. Marks: RA/RA
Remarks (if any): RA
Course(s) Studied/Studying other than Qualifying Examination (Starting from the latest):
__________________________________________________________________________________________________
Course

Yr. of Passing/Appearing

HIGH SCHOOL

2014

Board/Univ.

526

Roll No.

5755870

Permanent Address:
Address for Correspondence:
__________________________________________________________________________________________________
Address: SURYA VIHAR COLONY
TANKI WALA ROAD
ALIGARH - 202001(UP)

Address: SURYA VIHAR COLONY


TANKI WALA ROAD
ALIGARH - 202001(UP)

Phone 1: 8273407316

Email ID: americanprintingworks@gmail.com

Phone 2: 8273407316

Is hostel accommodation required? N (Hostel accommodation is not guaranteed; it is subject to availability of seats in the hostel)
__________________________________________________________________________________________________
DECLARATION: I SOLEMNLY UNDERTAKE to accept and abide by the rules of the Aligarh Muslim University and all the decisions of the Academic
Council & other appropriate University bodies in regard to my admission. I hereby solemnly affirm that I have gone through the Guide to Admissions
& its Supplement - U and solemnly declare on oath that the entries made by me in the above columns are true to the best of my knowledge and belief
and if at any time, the entries are found incorrect, the admission may outrightly be cancelled and disciplinary action may be initiated against me.
Transaction ID: 6639514/BSCB

20/01/2016-11:43

Thumb Impression
Male: Left Thumb, Female: Right Thumb

__________________________
Signature of the Candidate

FOR OFFICE USE ONLY

List of enclosures attached with the Application Form:

1.

DD/Cash Receipt in Original

2.

Self Attested copy of HS/SS Certificate in support of date of Birth

3.

Copies of Marksheets/Grade Sheets of all previous Examinations


passed/appeared including parts therein after passing High School

4.

If employed, copy of No Objection Certificate from the employer

Signature of Scrutiny Officer

5.

Documents in support of Internal Status/Spcl. Categ., if clamied*

6.

Copy of document(s), if rusticated/debarred or convicted by a court of law

Identity & Original Documents Verified


The candidate is eligible/not eligible for admission to

7.

________________________________________

8.

________________________________________

____________________________________
Remarks ____________________________

* Attach latest Marksheet/Document(s) in support, failing which your claim will be rejected

Verifying Officer ____________________

Hall Allotted:

Dept. of ___________________________
Date ____________________
Clearance by Proctor

DSW

Address Slips (for Office Use):

--------------------------------------------------------------------------------------------------------------------------------------Name: PUNEET KUMAR


Name: PUNEET KUMAR
Address: SURYA VIHAR COLONY
Address: SURYA VIHAR COLONY
TANKI WALA ROAD
TANKI WALA ROAD
ALIGARH - 202001(UP)
ALIGARH - 202001(UP)
Tel./Mobile: 8273407316
Tel./Mobile: 8273407316
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Name: PUNEET KUMAR
Name: PUNEET KUMAR
Address: SURYA VIHAR COLONY
Address: SURYA VIHAR COLONY
TANKI WALA ROAD
TANKI WALA ROAD
ALIGARH - 202001(UP)
ALIGARH - 202001(UP)
Tel./Mobile: 8273407316
Tel./Mobile: 8273407316
---------------------------------------------------------------------------------------------------------------------------------------

Transaction ID: 6639514/BSCB

Aligarh Muslim University


Scan Card, 2016-2017

(For Office Use only)

B.Sc. (Hons) Boys


Affix the same

Name: PUNEET KUMAR


Address:
SURYA VIHAR COLONY
TANKI WALA ROAD
ALIGARH - 202001(UP)
Tel./Mobile: 8273407316

Photograph as you
have uploaded in
the Application Form

Thumb Impression
Male(Left Thumb)/Female(Right Thumb)
Specimen Signature of the candidate

ACKNOWLEDGEMENT SLIP, AMU, Aligarh


Application form for admission to:
B.Sc. (Hons) Boys, 2016-2017
has been received.
App. No. is: _____________________
Transaction ID: 6639514/BSCB

To,
Name: PUNEET KUMAR
Address: SURYA VIHAR COLONY
TANKI WALA ROAD
ALIGARH - 202001(UP)
Tel./Mobile: 8273407316

POSTAL SLIP

(To be pasted on envelop containing the Application Form)

Application Form for Admission to


B.Sc. (Hons) Boys
To,
ASSTT./DY. CONTROLLER (ADMISSIONS)
ADMISSION SECTION, AMU,
ALIGARH - 202002 (UP)
From:
Name: PUNEET KUMAR
Address: SURYA VIHAR COLONY
TANKI WALA ROAD
ALIGARH - 202001(UP)
Tel./Mobile: 8273407316

6639514/BSCB

--------------------------------------------------------------------------------------------------Aligarh Muslim University


CANDIDATE'S SLIP

(Keep this Slip with you for future reference)


Course Applied for: B.Sc. (Hons) Boys
Transaction ID: 6639514/BSCB
_______________________________________________________________________________

INSTRUCTIONS

1. Please ensure that you have appended Photographs, Thumb Impression and Signature at the designated places on
the Application form.
Note: a) Use identical good quality color photographs taken not earlier than 3 months. The photographs should be taken preferably
wearing dark clothes on a white background.
b) Your Thumb Impression & Signature establish your identity hence, do not merely write your name in capital letters.

2. You must Ensure that all the documents along with Demand Draft is attached with the Application Form.
Note: Demand Draft (valid for 3 months) of the requisite amount should be drawn in favor of FINANCE OFFICER, AMU, payable at
Aligarh.

3. You must NOT make any type of correction(s) / modification(s) on the Application Form else your candidature may be
rejected.
4. Paste the 'POSTAL SLIP' given above on the A-4 size Envelope containing the Application Form and send it on the
Pre-Printed Address.
5. Please be a regular visitor to our website: www.amucontrollerexams.com which will provide you with necessary
updates regarding the status of your Application Form/Admission Test results etc.
6. Admit cards shall be available for download from the website. No Admit card shall be sent via postal mail.

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