COMPLETE APPLICATION FORM : JEE B.Ed.

- 2023

A - Registration Details
Registration Number BED202310123434
Candidate Name VARSHA SHAKYA
Candidate's Father Name RAKESH KUMAR SHAKYA
Candidate's Mother Name MEENA KUMARI
Candidate's Date of Birth 10/May/2001
Email Address shakyavarsha35@gmail.com
Primary Mobile Number 8090391879

B - Personal Details
Gender Female Marital Status Unmarried
Spouse Name Nationality Indian
Category SC Category Certificate Number 365174002523
State Domicile UP Is 10 From Up Yes
Is 12 From Up Yes Is UG From Up Yes
Is Person with Disability No Disability Type
Disability Percentage Is Economically Weaker
Id Proof Others Id Proof No
Alternate Email apr.narendra@gmail.com Alternate Mobile Number 8317075952
Do you belong to non creamy layer ?

C - Communication Address
30/1 PAL COLONY SIMARDHA JHANSI Jhansi Uttar Pradesh 284003

D - Permanent Address
30/1 PAL COLONY SIMARDHA JHANSI Jhansi Uttar Pradesh 284003

E - Opted Stream Details

Stream opted for B.Ed. Arts

F - SSC / 10th Std / Equivalent Details

Board Name UP Board
Marks Obtained 465 Maximum Marks 600
Year Of Passing 2016 Percentage 77.5
G - HSC / 12th Std / Equivalent Details
Board Name UP Board
Marks Obtained 348 Maximum Marks 500
Year Of Passing 2018 Percentage 69.6

H - Graduation Details
Is Graduation complete Pass Stream of Graduation Arts
Specified Stream Have you done BE/BTech
Name of University BUNDELKHAND UNIVERSITY JHANSI
Marks Obtained 531 Maximum Marks 1000
Percentage 53.1 Year Of Passing 2021
Roll Number 106182040993 Expected Year of Passing

I - Post Graduation Details

Is Post Graduation complete
Name of University
Marks Obtained Maximum Marks
Percentage Year Of Passing
Roll Number Expected Year of Passing

J - Weightage Details
TOTAL WEIGHTAGE : 0
A. Have you participated in National or State level or Inter University Sports Competition No
A.1. In the individual items by the Candidate

A.2. In the team items by the Candidate

A.3. In other college tournaments or sports run by a university

B. Are you Candidates of National Cadet Corps/National Service Scheme/Scout-Ranger Rovers?

C. Do you need reservation of dependents of freedom fighters No

D.
No
Are you in active service / immersed / retired defense personnel or son/daughter of such personnel, or related
to a disabled, missing or dead defensive personnel as their son/daughter/wife

E. Is your father or husband is serving in/retired from police or PAC or BSF or SSB or ITBP or CRPF or service in
home guards or disabled / dead in such services No
F. Female Candidate who is Widowed, Divorced or Abandoned

K - Center Details
Center Choice 1 Jhansi Center Choice 2 Lalitpur Center Choice 3 Kanpur Nagar
Center Choice 4 Agra Center Choice 5 Lucknow

L - Payment Details
Payment Status Success Payment Date 24/Feb/2023
Transaction Number YHDF1752792363 Receipt Number 20230224
Order Id BED20231012343420230224200050467 Total Amount 700

M - Declaration
I understand that it is my responsibility to check the eligibility criterion and other conditions of the J.E.E. B.Ed. 2023 – 25. I am also aware that the Bundelkhand University,
Jhansi is not verifying the eligibility at the time of submission of online application form. I, hereby, certify that the particulars given by me in this B.Ed. 2023 – 25 online
application form are true to best of my knowledge and belief and only I will be responsible for any mismatch or incorrect information. I also certify that I fulfil the
eligibility criteria laid down by Bundelkhand University, Jhansi for J.E.E. B.Ed. 2023 – 25 and undertake to produce original documents whenever necessary. I will follow all
instruction given by Bundelkhand University, Jhansi in this regard. I understand all disputes will be subjected to territorial jurisdiction of Jhansi City only.