सं युत वे श परीा (मु य)

Joint Entrance Examination (Main)

JEE(Main)
APPLICATION
240310351142
NUMBER
DO NOT SEND THIS PAGE TO NATIONAL TESTING AGENCY (NTA).
THE CANDIDATE IS REQUESTED TO RETAIN THE PRINTOUT OF THE CONFIRMATION PAGE FOR FUTURE REFERENCE.
यितगत योरा (Contact Details) वतमान पता (Present Address)
पता (Premises No/ Name) 36/323-4-1 ईमेल पता (Email Address) YADAVESWARREDDY098@GMAIL.COM
उप-थानीयता (Sub-
थानीयता (Locality) KADAPA OPP ADITYA FUNCTION HALL
Locality)(Optional)
दे श कोड (Country Code) 91 दे श (Country) INDIA
राय (State) ANDHRA PRADESH िजला (District) Y.S.R.
वै किपक संपक सू (Alternate
मोबाइल नंबर (Mobile Number) 91 - 9440433696 NA
Contact No.) (Optional)
िपन कोड (Pin Code) 516002
थायी पता (Permanent Address)
पता (Premises No/ Name) 36/323-4-1 थानीयता (Locality) KADAPA
उप-थानीयता (Sub- OPP ADITYA FUNCTION
दे श (Country) INDIA
Locality)(Optional): HALL
राय (State) ANDHRA PRADESH िजला (District) Y.S.R.
िपन कोड (Pin Code) 516002
यितगत योरा (PERSONAL DETAILS)
CHINNADANDLURU अयथी की जम ितिथ
अयथी का नाम (Candidate's Name) 26-06-2007
YADAVESWAR REDDY (Candidate's Date of Birth)
CHINNADANDLURU
िपता / अिभभावक का नाम (Father / माता / अिभभावक का नाम (Mother
VENKATA SIVASANKAR CHINNADANDLURU UMARANI
Guardian Name) / Guardian Name)
REDDY
िलंग (Gender) MALE राटीयता (Nationality ) INDIAN
ANY OTHER VALID
पहचान संया (Identification
पहचान के कार (Identity Type) GOVT IDENTITY WITH 263813412788
Number)
PHOTOGRAPH
राय / केद शािसत दे श जहाँ से 12वीं
/ समक उीण / उपिथत (State/ UT
ANDHRA PRADESH े णी (Category ) GENERAL
from where 12th/ Equivalent
Passed/ Appearing)
या आपको मधुमेह ह  (Are You िनवास की जगह ( Place of
NO URBAN
Diabetic ? ) Residence )
यिद आप एक Pwd उमीदवार ह , तो
या आपके पास ब चमाक िवकलांगता है वािषक पािरवािरक आय ( Annual
NA 800000 AND ABOVE
(If you are a Pwd Candidate, do Family Income )
you have benchmark disability)?
योयता परीा म कू ली िशा का
तैयारी का तरीका ( Mode of
Self-Study 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.E./B.Tech Session 1 & Session 2
(Session Of Exam Apply For)
िपता / अिभभावक यवसाय (Father / िपता / अिभभावक योयता (Father
GOVERNMENT SERVICE Graduate
Guardian Occupation) / Guardian Qualification)
माता / अिभभावक योयता
माता / अिभभावक यवसाय (Mother /
Others (Mother / Guardian MATRICULATE
Guardian Occupation)
Qualification)
परीा राय-पहला िवकप (Exam परीा शहर-पहला िवकप (Exam
ANDHRA PRADESH KADAPA
State 1st Choice ) City 1st Choice )
परीा राय-दूसरा िवकप (Exam परीा शहर-दूसरा िवकप (Exam
ANDHRA PRADESH PRODDATUR
State 2nd Choice ) City 2nd Choice )
परीा राय-तीसरा िवकप (Exam परीा शहर-तीसरा िवकप (Exam
ANDHRA PRADESH TIRUPATHI
State 3rd Choice ) City 3rd Choice )
परीा राय-चौथा िवकप (Exam परीा शहर-चौथा िवकप (Exam
ANDHRA PRADESH NANDYAL
State 4th Choice ) City 4th Choice )
न प मायम (Question Paper Medium) English
th
10वीं या समक योयता िववरण (10 or equivalent Qualification Details)
उीण / सिमिलत होने का वष
उीण की िथित (Pass Status) Passed 2022
(Year of Passing/Appearing)
कू िलंग का थान (Place of
योयता परीा (Qualifying Exam) 10 th or equivalent Urban
Schooling)
कू ल / कॉलेज का कार (Type of योयता परीा राय (Qualifying
Private Unaided ANDHRA PRADESH
School / College) Examination State)
योयता परीा िजला (Qualifying ANDHRA PRADESH BOARD OF
Y.S.R. कू ल बोड (School Board)
Examination District) SECONDARY EDUCATION
का 10वीं की माकशीट/माणप के
अनुसार िवालय/कॉलेज का नाम
NAGARJUNA MODEL कू ल / कॉलेज का पता (School /
(School/College name should be as MARUTHI NAGAR, KADAPA
SCHOOL College Address)
per Class 10th Mark
sheet/certificate)
रोल नंबर 10वीं माणप के अनुसार
कू ल / कॉलेज िपनकोड (School /
516002 (Roll number as per 10th 2222103147
College Pincode)
certificate)
पिरणाम मोड (Result Mode) Percentage पूणा क (Total Marks) 600.0
ातांक (Obtain Marks) 533.0 ितशत (Percentage) 88.83
th
12वीं या समक योयता िववरण (12 or equivalent Qualification Details)
उीण / सिमिलत होने का वष
उीण की िथित (Pass Status) Appearing 2024
(Year of Passing/Appearing)
Intermediate or two-year
Pre-University examination कू िलंग का थान (Place of
योयता परीा (Qualifying Exam) Urban
conducted by a recognized Schooling)
Board/ University.
कू ल / कॉलेज का कार (Type of योयता परीा राय (Qualifying
Private Unaided ANDHRA PRADESH
School / College) Examination State)
योयता परीा िजला (Qualifying ANDHRA PRADESH BOARD OF
Y.S.R. कू ल बोड (School Board)
Examination District) INTERMEDIATE EDUCATION
का 12वीं की माकशीट/माणप के
अनुसार िवालय/कॉलेज का नाम
NARAYANA JUNIOR कू ल / कॉलेज का पता (School /
(School/College name should be as NGO COLONY, KADAPA
COLLEGE College Address)
per Class 12th Mark
sheet/certificate)
रोल नंबर 12वीं माणप के अनुसार
कू ल / कॉलेज िपनकोड (School /
516002 (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
NO
ह (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) 9704205336 ईमेल आईडी (Email ID) mahaparishada@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) 164195219
लेन-दे न की ितिथ (Date of
परीा शु क (Exam Fee) 2000.0 13-11-2023 14:41:03 PM
Transaction)
शु क जमा िकया गया (Fee Submitted
13-11-2023 14:40:36 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 : 106.221.179.119 Date of Downloading : 08-02-2024 14:35:53 PM