Application No.

: 90342783 ALIGARH MUSLIM UNIVERSITY

Session : 2022-23 GENERAL
Application Form for admission to
XI Science & Diploma in Engineering
Senior Secondary Schools/Polytechnic

PAYMENT NOT SUCCESSFUL, FORM NOT SUBMITTED Nationality: India

Preference for Test Centres:
1. Lucknow (U.P.) 2. Aligarh (U.P.) XI/Diploma preferences: Science only
Personal Details:
Name: ALEEZA FATMA Date of Birth: 18 July, 2007
Father's Name: MUJAHID HASAN Gender: FEMALE
Mother's Name: NASEEM FATMA Religion: Islam
Details of Qualifying Examination: Status & Special Categories:
Examination: HIGH SCHOOOL Status:
Roll No.: 7564837 Enrolment No.:
Year of Passing/Appearing: 2022 Hall:
Board/Univ.: Council for the Indian School Special Categories:
Certificate Examinations,. Delhi Phone 1: 9415270925 Phone 2: 7007852918
Percentage: % Email: naseemfatma9415@gmail.com
Remark (if any).: Is hostel accommodation required? YES#
Name of the Examination Board/University Year Roll No. % of Marks
HIGH SCHOOOL Council for the Indian School Certificate 2022 7564837
Examinations,. Delhi
Address for Correspondence Permanent Address
415, KUNTI NAGAR COLONY, HUMAYUN PUR NORTH 415, KUNTI NAGAR COLONY, HUMAYUN PUR NORTH
GORAKHNATH, GORAKHPUR, GORAKHPUR GORAKHNATH, GORAKHPUR, GORAKHPUR
Uttar Pradesh, 273015, India Uttar Pradesh, 273015, India

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 & Supplements applicable for this
course 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.
# Hostel accommodation is not guaranteed; it is subject to availability of seats in the hostel

Application No. 90342783/SCXX

For office use (Procotor's Office) For office use (DSW's Office)

Page 1/1

Powered by TCPDF (www.tcpdf.org)