Application No.

: 90254532 ALIGARH MUSLIM UNIVERSITY

Session : 2022-23 GENERAL
Application Form for admission to Selected/Chance Memo/
XI Humanities/Commerce Special Category Rank
Senior Secondary Schools Roll No.: 4068315
Rank:
Category 1:
Category 2:
Category 3:

Transaction No.: 514766 / 1787466300, Date: 07-05-2022 20:38:45, Amount: 700 Nationality: India
Preference for Test Centres:
1. Aligarh (U.P.) 2. Bareilly (U.P.)
Personal Details:
Name: MOHD HAMZA ADIL KHAN Date of Birth: 03 November, 2006
Father's Name: MOHD ADIL KHAN Gender: MALE
Mother's Name: AMREEN ADIL Religion: Islam
Details of Qualifying Examination: Status & Special Categories:
Examination: HIGH SCHOOL Status:
Roll No.: Enrolment No.:
Year of Passing/Appearing: 2022 Hall:
Board/Univ.: Central Board of Secondary Special Categories:
Education, Delhi Phone 1: 9557080879 Phone 2: 9412376155
Percentage: % Email: hamzakhankhan807@gmail.com
Remark (if any).: Is hostel accommodation required? YES#
Name of the Examination Board/University Year Roll No. % of Marks
HIGH SCHOOL Central Board of Secondary Education, Delhi 2022
Address for Correspondence Permanent Address
0, MOHALLA NAI SARAI, NEAR TELEPHONE 0, MOHALLA NAI SARAI, NEAR TELEPHONE
EXCHANGE EXCHANGE
BADA DARWAZA, BUDAUN, BUDAUN BADA DARWAZA, BUDAUN, BUDAUN
Uttar Pradesh, 243601, India Uttar Pradesh, 243601, 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. 90254532/ATXX

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

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