JNM College for Advance Studies & Technology

Khushaal Nagar, Sector-A Near, Natiniya Mai Mandir,

Bhojubeer - Basahi Road, Cantt,Varanasi
Uttar Pradesh-221002
Toll-Free : +91-9005816414, +91-8573993399
Email : jnmcollege2014@gmail.com
Application ID : JNM/2023/0082

Application Form

Registration Details

Name Sourabh Saxena

Contact No. +91-8800749808
Aadhaar Card Number 679640120293
Email ID saxenasaurabh.dce@gmail.com
Date of Birth 1986-11-10
Gender Male
Program PG
Course MSc-Math
Category General
Nationality Indian
Religion Hindu

Address Details

Permanent Address Present Address

Permanent Address Line 1 C-12, Pandav Nagar Present Address Line 1 S-17/317B
Permanent Address Line 2 Near Mother Dairy Present Address Line 2 Nadesar Cantt. area
Permanent Country India Country India
Permanent State Uttar Pradesh Present State Uttar Pradesh
Permanent City Varanasi Present City Varanasi
Permanent PINCODE 110092 PIN Code 221002

Academic Details

10th Details 12th Details

Class 10th Board CBSE Class 12th Status Declared - Passed
Maximum Marks/CGPA 500.00 Class 12th Board CBSE
Obtained Marks/CGPA 434.00 Maximum Marks/CGPA 500.00
Year of Passing 2003 Obtained Marks/CGPA 462
Class 10th Board-Other - Year 2005
Stream Science
Stream Other -
Board Other -
Graduation Details Payment Details
UG-University Name Delhi University I agree to pay the application Yes
Processing Fee
UG-Institute Delhi College of Engineering
(Now DTU) Application Fee Status Unpaid

UG-Programme B.E. Paid Application Amount 500

UG Status PASSED Application Fee Transaction ID 320482124863

UG Programme - Others - Application Fee Transaction Date -

UG Maximum Marks/CGPA 100.00

UG Obtained Marks/CGPA 79.00
UG Year of Passing 2009

Parents Details
Father's / Husband's Name Sh. Satish Saxena
Mother's Name Smt. Nishi Saxena

Guardian Details
Guardian's Name Sh. Amit Srivastava
Guardian's Mobile Number +91-9794861404

DECLARATION / TERMS & CONDITIONS

1. Certi ed that the information given above is correct and that
2. I agree with the basic values and methods of education of the college as and when they are modi ed from time to time I undertake to
adhere to the requirements of the college, regarding prompt payment of fees and others deposits, leave rules; clothing, settlement of
accounts in case of with drawls promotion and detention in college etc.
3. I am ready to abide by the rules/ regulations of the college, as I have read the registration form of the JNM College For Advance Studies
&Technology, thoroughly.
4. I certify that his/her date of birth as stated herein is correct. I agree to abide by the rules of college. I understand that
principal/Management has the nal authority either to accept or reject this application, and even to cancel his/her admission for any
misconduct or indiscipline by the student or guardian in mid-session as well.
5. I willingly agree to the following terms:
. For any sudden or natural incident, none from the Management, Principal, Teacher and non-Teaching staff etc. will be held responsible.
7. All disputes are subject to Varanasi court of jurisdiction.
. JNM College for Advance Studies and Technology will not be held responsible for any loss to life & property of a hostler/ day scholar in any
condition, not claim for any compensation would be entertained.
9. Money deposited once will not be return in any conditions.
10. I/we have read the rules and regulations for JNM College for Advance Studies and Technology, Varanasi. I/We/am /are fully satis ed and
willingly wish to admit my/our wad here and abide by all the rules and regulations.
11. Also, for any physical injury in playground, transportation, natural calamities or likewise unforeseen future eventuality amounting to
permanent disability or demise. I/We would never label any blame or liability thereof to the college and authority.

Applicant Name: Sourabh Saxena Declaration Date: 2023-07-24 Declaration Place: Varanasi