Uttar Pradesh State Entrance Examination - 2018

Dr. A P J Abdul Kalam Technical University Uttar Pradesh, Lucknow

Confirmation Page

Application No. 1106145 -

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CANDIDATES ARE REQUESTED TO RETAIN THE PRINTOUT OF ACKNOWLEDGEMENT PAGE FOR FUTURE REFERENCE.

Personal Details /
Name : STUTI TIWARI Date of Birth : 28-03-2001
Mother's Name : NANDITA TIWARI Category : UPGE
Father's Name : PRAMOD KUMAR TEWARI SubCategory : Not Applicable
Gender : Female Nationality : Indian
Rural weightage claimed : No Parent Domicile : UTTAR PRADESH
Qualifying examination passed/appeared UTTAR PRADESH
from college situated in :

Applying For :
Apply For : UG
Qualifying Exam : INTERMEDIATE
Entrance Examination City Lucknow(OMR Based Exam ( For Paper 1, 2, 3 Entrance Examination City Kanpur Nagar(OMR Based Exam ( For Paper 1,
1st : & 4 only) & Computer Based Test (For Paper 5, 2nd : 2, 3 & 4 only) & Computer Based Test (For
6,7 &8 only)) Paper 5, 6,7 &8 only))
Entrance Examination City Faizabad(OMR Based Exam ( For Paper 1, 2, 3
3rd : & 4 only))

Education Details :
Qualification Pass Course/Stream Name Board/University Name Year Of Marks (%) Roll No. Institute Name & Address Pincode
Status Passing
INTERMEDIATE Appeari INTERMEDIATE COUNCIL FOR THE INDIAN 2018 6143185 St.Dominic Savio Inter 226016
ng SCHOOL CERTIFICATE College
EXAMINATIONS

Subject in 10+2 :
Chemistry (Theory + Practical) , Computer Science , English , Mathematics , Physics (Theory + Practical)

Seeking Admission & Course Applied For Details :

Seeking Admission For : FIRST YEAR
Courses Applied For 1st Year Admission : B.Tech.
Paper(S) In Which You Wish To Appear In See-AKTU : Paper 1

Contact Details :
Communication B-27 NARAYAN NAGAR City/Town/Village : FAIZABAD ROAD LUCKNOW
Address :
District : LUCKNOW State : UTTAR PRADESH
Pin Code : 226016 Email Address : pra********@gmail.com
Mobile Number : 991****707 Land Line No. with --
(+91) STD Code :

Fee Payment Details

Payment Mode: Pay through ICICI Transaction ID: 471657088
Exam Fee: 650 /- Date of Transaction: 09-03-2018 18:07:19
Fee Submitted On: 09/03/2018
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 Board
procedures. I shall abide by the terms and conditions thereon.

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Date of Printing : 09/03/2018 06:06:31 PM