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  • JEE (Main) AcknowledgementPage

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    Priyansh shukla
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    This document is an acknowledgement page from the Central Board of Secondary Education (CBSE) for Priyansh Shukla's application to the Joint Entrance Examination (Main) - 2018. It provides personal details of Priyansh such as his name, date of birth, gender, address, school and academic details. It also lists the payment details including the mode of payment and transaction details for the examination fee.

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    This document is an acknowledgement page from the Central Board of Secondary Education (CBSE) for Priyansh Shukla's application to the Joint Entrance Examination (Main) - 2018. It provides personal details of Priyansh such as his name, date of birth, gender, address, school and academic details. It also lists the payment details including the mode of payment and transaction details for the examination fee.

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    © All Rights Reserved
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    17 views1 page

    JEE (Main) AcknowledgementPage

    Uploaded by

    Priyansh shukla
    This document is an acknowledgement page from the Central Board of Secondary Education (CBSE) for Priyansh Shukla's application to the Joint Entrance Examination (Main) - 2018. It provides personal details of Priyansh such as his name, date of birth, gender, address, school and academic details. It also lists the payment details including the mode of payment and transaction details for the examination fee.

    Copyright:

    © All Rights Reserved
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    Joint Entrance Examination (Main) - 2018

    CENTRAL BOARD OF SECONDARY EDUCATION


    ACKNOWLEDGEMENT PAGE

    Application No. 80040477


    DO NOT SEND THIS PAGE TO CBSE.
    CANDIDATES ARE REQUESTED TO RETAIN THE PRINTOUT OF ACKNOWLEDGEMENT PAGE FOR FUTURE REFERENCE.

    Personal Details
    Name: PRIYANSH SHUKLA Date of Birth: 27/12/2000
    Mother's Name: RAJNI SHUKLA Category GENERAL
    Caste Name NA Father's Name: ARUN SHUKLA
    Person with Disability(PwD): NO State of Eligibility: MADHYA PRADESH
    Percentage of Disability: -- Gender: MALE
    Are you Diabetic :: NO Nationality: INDIAN
    Place of Residence: URBAN You need scribe/reader ?: NO

    Examination Details
    Applying For: JEE(Main) Paper - 1 and Paper - 2 Both
    Examination Mode (B.Tech.): PEN AND PAPER BASED EXAMINATION Examination Mode (B.Arch.): PEN AND PAPER BASED EXAMINATION
    Question Paper Medium: ENGLISH 1st Choice of Exam Centre: REWA
    2nd Choice of Exam Centre: JABALPUR 3rd Choice of Exam Centre: BHOPAL
    4th Choice of Exam Centre: INDORE

    Academic Details
    Year of passing class 10th: 2016 Place of 12th class schooling: CITY
    Year of Passing or Appearing class 12th/Qualifying Exam: 2018 Type of Institution of Class 12th/Qualifying Exam: GOVERNMENT
    School Board of class 12th/Qualifying Exam: CENTRAL BOARD OF SECONDARY EDUCATION
    Name of the Qualifying Examination passed / appearing: The final examination of the 10+2 system, conducted by any recognized central/ state Board, such as Central
    Board of Secondary Education, New Delhi; Council for the Indian School Certificate Examinations, New Delhi;
    etc.
    Percentage of Marks in Class 12th/Qualifying Exam: -- Roll No. of Class 12th/Qualifying Exam: --
    Appeared/Appearing for Improvement of Class NO Mode of preperation: SELF STUDY
    12th/Qualifying Exam:
    Roll Number of Class 12th/Qualifying Examination of
    Improvement Examination:
    Name and Address of the School/College from where KENDRIYA VIDHYALAYA NO.2 CIVIL LINES, REWA
    passed/appearing:

    Candidate's Mailing Address


    Country: India State: MADHYA PRADESH
    District: REWA Address: H.No. 25/224, Near Sondhiya Bakery, PTS Chowk
    Locality: Chankya Nagar City/Town/Village: Rewa
    Pin Code: 486001

    Guardian Details
    Qualification Occupation Annual Income
    Father's/Guardian's: POST GRADUATE PUBLIC SECTOR SERVICE RS. 700001-800000
    Mother's: GRADUATE OTHERS --

    Payment Details
    Provider Name: ICICI Bank Payment Mode: Electronic Payment Gateway
    Fee Type: Examination Fee Transaction Amount: 1800 /-
    Transaction ID: 414727002 Date of Transaction: 03-12-2017 11:04:40
    DECLARATION
    I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. I have read and understood the JEE procedures for both
    JEE(Main) and JEE(Advanced) - 2018. I shall abide by the terms and conditions thereon.

    Images Uploaded by Candidate


    Candidate Photograph Candidate Signature Parent/Guardian Signature

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