सं युत वे श परीा (मु य)

Joint Entrance Examination (Main)

JEE(Main)

APPLICATION NUMBER 240320035915

DO NOT SEND THIS PAGE TO NATIONAL TESTING AGENCY (NTA).
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यितगत योरा (Contact Details) वतमान पता (Present Address)
पता (Premises No/ Name) H-NO 6/64 ईमेल पता (Email Address) PRASAD44270@GMAIL.COM
GANGASTHAN PHASE 2, उप-थानीयता (Sub-
थानीयता (Locality) NA
ROAD NO. 3 Locality)(Optional)
दे श कोड (Country Code) 91 दे श (Country) INDIA
राय (State) TELANGANA िजला (District) Nizamabad
वै किपक संपक सू (Alternate
मोबाइल नंबर (Mobile Number) 91 - 9030344270 NA
Contact No.) (Optional)
िपन कोड (Pin Code) 503002
थायी पता (Permanent Address)
पता (Premises No/ Name) H-NO 6/64 थानीयता (Locality) GANGASTHAN PHASE 2, ROAD NO. 3
उप-थानीयता (Sub-
NA दे श (Country) INDIA
Locality)(Optional):
राय (State) TELANGANA िजला (District) Nizamabad
िपन कोड (Pin Code) 503002
यितगत योरा (PERSONAL DETAILS)
POTHIREDDY अयथी की जम ितिथ (Candidate's
अयथी का नाम (Candidate's Name) 14-06-2007
SREESHANTH REDDY Date of Birth)
िपता / अिभभावक का नाम (Father / POTHIREDDY PRASAD माता / अिभभावक का नाम (Mother /
POTHIREDDY VARALAXMI
Guardian Name) REDDY Guardian Name)
िलंग (Gender) MALE राटीयता (Nationality ) INDIAN
ANY OTHER VALID GOVT
पहचान संया (Identification
पहचान के कार (Identity Type) IDENTITY WITH 890170147830
Number)
PHOTOGRAPH
राय / केद शािसत दे श जहाँ से 12वीं /
समक उीण / उपिथत (State/ UT
TELANGANA े णी (Category ) GEN-EWS
from where 12th/ Equivalent Passed/
Appearing)
या आपको मधुमेह ह  (Are You िनवास की जगह ( Place of Residence
NO URBAN
Diabetic ? ) )
यिद आप एक Pwd उमीदवार ह , तो या
आपके पास ब चमाक िवकलांगता है (If वािषक पािरवािरक आय ( Annual
NA 200001-300000
you are a Pwd Candidate, do you Family Income )
have benchmark disability)?
योयता परीा म कू ली िशा का
तैयारी का तरीका ( Mode of
Tutorial Classes in School मायम ( Medium of schooling in English
Preparation )
qualifying exam )
परीा कद िववरण (Exam centre Details)
परीा के स के िलए आवे दन कर
के िलए आवे दन (Apply For) B.Arch. Session 2
(Session Of Exam Apply For)
िपता / अिभभावक यवसाय (Father / िपता / अिभभावक योयता (Father /
SELF-EMPLOYMENT Graduate
Guardian Occupation) Guardian Qualification)
माता / अिभभावक यवसाय (Mother / माता / अिभभावक योयता (Mother /
Others OTHERS
Guardian Occupation) Guardian Qualification)
परीा राय-पहला िवकप (Exam State परीा शहर-पहला िवकप (Exam City
TELANGANA NIZAMABAD
1st Choice ) 1st Choice )
परीा राय-दूसरा िवकप (Exam State परीा शहर-दूसरा िवकप (Exam City
TELANGANA HYDERABAD/SECUNDERABAD
2nd Choice ) 2nd Choice )
परीा राय-तीसरा िवकप (Exam परीा शहर-तीसरा िवकप (Exam City
TELANGANA KARIMNAGAR
State 3rd Choice ) 3rd Choice )
परीा राय-चौथा िवकप (Exam State परीा शहर-चौथा िवकप (Exam City
TELANGANA WARANGAL
4th Choice ) 4th Choice )
न प मायम (Question Paper Medium) English
10वीं या समक योयता िववरण (10th or equivalent Qualification Details)
उीण / सिमिलत होने का वष (Year of
उीण की िथित (Pass Status) Passed 2022
Passing/Appearing)
योयता परीा (Qualifying Exam) 10 th or equivalent कू िलंग का थान (Place of Schooling) Urban
कू ल / कॉलेज का कार (Type of School योयता परीा राय (Qualifying
Private Unaided TELANGANA
/ College) Examination State)
योयता परीा िजला (Qualifying TELANGANA BOARD OF
Nizamabad कू ल बोड (School Board)
Examination District) SECONDARY EDUCATION
का 10वीं की माकशीट/माणप के
अनुसार िवालय/कॉलेज का नाम
POTHIREDDY SREE कू ल / कॉलेज का पता (School /
(School/College name should be as niamabad mubaraknagar
SHANTH REDDY College Address)
per Class 10th Mark
sheet/certificate)
रोल नंबर 10वीं माणप के अनुसार
कू ल / कॉलेज िपनकोड (School /
503002 (Roll number as per 10th 2205103737
College Pincode)
certificate)
अिधकतम ग े ड वाइंट (Max Grade
पिरणाम मोड (Result Mode) CGPA 10.0
Point)
सीजीपीए ात िकया (Obtained संचयी ितशत (Cumulative
8.3000000000000007 78.85
CGPA) Percentage)
12वीं या समक योयता िववरण (12th or equivalent Qualification Details)
उीण / सिमिलत होने का वष (Year of
उीण की िथित (Pass Status) Appearing 2024
Passing/Appearing)
Intermediate or two-year Pre-
University examination
योयता परीा (Qualifying Exam) कू िलंग का थान (Place of Schooling) Urban
conducted by a recognized
Board/ University.
कू ल / कॉलेज का कार (Type of School योयता परीा राय (Qualifying
Private Unaided TELANGANA
/ College) Examination State)
योयता परीा िजला (Qualifying TELANGANA STATE BOARD OF
Medchal Malkajgiri कू ल बोड (School Board)
Examination District) INTERMEDIATE EDUCATION
का 12वीं की माकशीट/माणप के
अनुसार िवालय/कॉलेज का नाम
कू ल / कॉलेज का पता (School / sy. no 1008, opp: orr, upperapally village,
(School/College name should be as excellencia junior college
College Address) shamirpet, medchal
per Class 12th Mark
sheet/certificate)
रोल नंबर 12वीं माणप के अनुसार
कू ल / कॉलेज िपनकोड (School /
500078 (Roll number as per 12th NA
College Pincode)
certificate)
अितिरत जानकािरयां (Additional Details)
या आप जु ड़वा ह और दोनों जे ईई (मे न) - 2024 के िलए आवे दन कर रहे ह
NO
(Are you a Twin and both applying for JEE (MAIN) – 2024)?
आपातकालीन संपक िववरण प (Emergency Contact Details)
दे श (Country) INDIA दे श कोड (Country Code) +91
मोबाइल नंबर (Mobile Number) 9059068068 ईमेल आईडी (Email ID) sreeshanth0224@gmail.com
उमीदवार ारा अपलोड की गई छिवयां (IMAGES UPLOADED BY THE CANDIDATE)

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शु क भु गतान िववरण (Fee Payment Details)

भु गतान का कार (Payment Mode) Online लेन-दे न आईडी (Transaction ID) ZIC51738630751
लेन-दे न की ितिथ (Date of
परीा शु क (Exam Fee) 900.0 09-02-2024 17:17:27 PM
Transaction)
शु क जमा िकया गया (Fee Submitted
09-02-2024 17:16:46 PM
On)
घोषणा (Declaration)
I declare that information furnished by me in the application form is true in all respect and nothing is concealed. In case any entry or information is found to
be false, this shall entail automatic cancellation of my admission besides rendering me liable to such actions as deemed fit by the University. I hereby
undertake that I have carefully gone through the eligibility conditions prescribed in the prospectus for the programme. I am applying after satisfying that I
meet the eligibility conditions. If at any stage it is found that I do not fullfill the minimum prescribed criteria, my admission, if granted, shall stand cancelled
and I shall have no right to admission whatsoever.
IP Address : 27.116.21.42 Date of Downloading : 09-02-2024 17:19:14 PM