JOINT ENTRANCE EXAMINATION (Main) - APRIL 2020

Confirmation Page

Application No. 200310446186 -

DO NOT SEND THIS PAGE TO NATIONAL TESTING AGENCY (NTA).
CANDIDATE IS REQUESTED TO RETAIN THE PRINTOUT OF CONFIRMATION PAGE FOR FUTURE REFERENCE.

Personal Details
Candidate's Name KOTAGARAM VAISHNAVI Candidate's Date of Birth 13-05-2002
Mother's Name K SUMATHI Category OBC- NCL (Central List)
Father's Name K PRABHAKAR Gender Female
In case of Girl candidate, Are you only girl NO If you are a PwD Candidate, No
child of your parents? do you have benchmark
disability (40% or more /
“Severe” where percentage is
not defined) ?
Nationality Indian Place of Residence Rural
State Code of Eligibility ANDHRA PRADESH Are You Diabetic? NO
Medium of Instructions/Study - Physics, English Mode of Preparation Self Study
Chemistry and Mathematics in Class
11th/12th/equivalent

Apply For
Apply For B.E./B.Tech. Only Question Paper Medium English
Exam City 1st ANDHRA PRADESH - CHITTOOR Exam City 2nd ANDHRA PRADESH - TIRUPATHI
Exam City 3rd TAMIL NADU - VELLORE Exam City 4th ANDHRA PRADESH - NELLORE

Additional Details
Are you a Twin No

Contact Details
Address NO 1-93 MANGUNTA VILLAGE Locality MANGUBNTA POST
City/Town/Village S R PURAM MANDAL District CHITTOOR
State ANDHRA PRADESH Pin Code 517167
Email Address kva************@gmail.com Mobile Number 810****941
Land Line No. with --
STD code or any
other Contact No.

Fee Payment Details

Payment Mode: Pay through ICICI Bank Transaction ID: 1035787008
Exam Fee: 325 /- Date of Transaction: 26/02/2020 11:40:15
Fee Submitted On: 26/02/2020
DECLARATION
I hereby declare that all the particulars given by me in this form are true to the best of my knowledge and belief and any mistake / misinformation, detected at the time
of admission or at any stage in future, will result in the cancellation of admission/candidature. I have read the information bulletin and understood all the procedures. In
case I furnish any false information, my result will not be declared/ my candidature will automatically stand cancelled. I shall abide by terms and conditions therein. No
Candidate should adopt any unfair means, or indulge in any unfair examination practices. If at any stage, it is found that the candidate has submitted multiple
Applications and/or appeared in more than one date/shift, then the candidature will be cancelled and legal action will be taken including debarring in all future
examinations conducted by NTA

Images Uploaded by Candidate

Photograph Signature

List of Document Uploaded

Photograph,Signature,12th Admit Card/Marksheet/Certificate

IP Address : 103.110.168.187 Date of Downloading : 26/02/2020 11:41:01 AM