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Application for PET-2019

[Test Mode :COMPUTER BASED TEST (CBT)]

REGISTRATION NO: BHU00456882340 PAYMENT ID: BHUP54568820642z

IDENTIFICATION TYPE : Aadhaar Card IDENTIFICATION NO. Not Applicable for Aadhaar Card

Course Code & Name: (340) M. Sc. (Ag.)

卵Ţ 卵 卵 :
Candidate Name: SUBHANKAR BHATTACHERJEE
朗  卵 卵 :
Father's Name: RANJAN BHATTACHERJEE
欄卵 卵 卵 :
Mother's Name: BHARATI BHATTACHERJEE
卵卵 卵 卵:
Father's / Mother's Mobile
Number:
欄卵 / 卵卵 卵 來卵 濾  :
Date of Birth: 02. November .1996
ɉ 欄欄 :

Sex/欄濾: MALE Category/Ŋ: General

Blood Group: Do you claim Reservation for NO
ɰ Ť藍 : Economically Weaker Section (EWS) ?
Physically Challenged: NO Employee's Ward: NO
卵濫į 欄卵濾 卵: Ŋ 卵濫 藍 ũ藍 ũ濫 :

Nationality/卵ʼŌ濫卵 : Indian Sports Seat: NO

˙來盧Ŋ 車 車濫 :
Religion/Ŋ : HINDU
Do you belong to "BHU Student NO
Category"?:
Ɛ卵  濫..襤 欄卵Ŏ 濫 ŵ朗 濫 œ 賈œ

Address For Correspondence ũ卵卵 卵 卵 Permanent Address ̾卵濫 卵

Name: SUBHANKAR BHATTACHERJEE Guardian's Name (If
朗 卵 卵 Applicable)

Address (卵 ) : A-2/103(A) Address (卵 ) : A-2/103(A)

District (欄卵): Nadia District (欄卵): Nadia

State (卵Ǜ): West Bengal State (卵Ǜ): West Bengal

Pin (欄) : 741235 Pin (欄) : 741235

Ph. No. with STD Code Ph. No. with STD Code

Mobile No. (來卵 濾 ) 7003188638 Fax No.

Email subhankar.1173@gmail.com Mobile No. (來卵 濾 ) 7003188638

Distance of your Residence from 500-999 Annual Income of your Between 2,00,000 and 3,00,000
BHU . Parents/Guardians in Rs.

Test Center Preference 濫Ɨ卵 朗Ⱦ į卵 Test Mode : COMPUTER BASED TEST (CBT)
Preference - 01 Kolkata [ West Bengal ] Preference - 04 Dhanbad [ Jharkhand ]
Preference - 02 Asansol [ West Bengal ] Preference - 05 Jamshedpur [ Jharkhand ]
Preference - 03 Siliguri [ West Bengal ]

Signature Uploaded by
the candidate
ɷŎ Ȫ卵卵 來朗 
賈ˑ卵Ɨ

It is hereby confirmed that I have carefully read the concerned Information Bulletin available on the BHU's Entrance Test Portal (www.bhuonline.in) before filling up the Application Form.
I hereby solemnly affirm that the information furnished in this Online Application Form is true and correct to the best of my lnowledge and belief and no material information has been concealed or
suppressed. If any information is found to be false, incorrect or misleading, the Banaras Hindu University shall have the authority to cancel my candidature / admission without any further enquiry or
notice.
I undertake that, if admitted, I shall abide by the UGC Regulations on Curbing the Menace of Ragging, 2009, Ordinances governing the discipline of students of banaras Hindu University and such other
Rules, Ordinances and Regulations that may be framed by the Banaras Hindu University/ UGC from time to time.
I further undertake that the preference for the Test center, Courses, Domicile and the categories to which I belong as indicated by me in the online application form shall be irrevocable.

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