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Application for SCHOOL : For Class IX

SESSION-2024
Application Id:
BHU0250653102

1. Personal Information:
Name: SHIKHA SINGH Date of Birth: 27 February 2011
Registered Mobile No. : 7080009975 Registered Email Id : Nirbhay4635@gmail.com
Gender: Female Category : OBC-NCL
Physically Challenged: No NCC Certificate: No
Father's Name: Kismat Singh Mother's Name: Sushama Singh
BHU Employee Ward: No Employee Id: N/A

2. Permanent Address:
Address Line 1: Koiran Bazar, Near Maurya Lawn, Mirzapur
PIN Code: 231301 State: Uttar Pradesh
Alternate Mobile No: 7080009975

3. Communication Address:
Address Line 1: Koiran Bazar, Near Maurya Lawn, Mirzapur
PIN Code: 231301 State: Uttar Pradesh
Alternate Mobile No: 7080009975

4. Bank Details:
Bank Name: PNB Branch Name: Aharaura
Bank A/C No: 7820001700015575 Bank IFSC Code: PUNB07820
Account Holder Name: Shikha Singh

5. Payment Details:
Order ID: order_Ni9hcyuqFZUBwO Payment Date Time: 04-03-2024 10:34 AM
Amount: 800 Payment ID: pay_Ni9jr86vX3rypy

Declaration/ Undertaking by the Candidate:

I hereby declare that all the particulars given in this application form by me are true and no fact has been suppressed or tempered. I have read th
bulletin for the School Admission 2024 and the terms and conditions given therein and satisfied myself that I fulfill all the admission eligibility req
any information furnished by me is found wrong, my candidature for the admission test be cancelled outright without giving any opportunity and
disciplinary action be also taken against me.

Countersigned by the Parent/ Guardian : Full Signature of the candidate :

Date: 04-03-2024, Application Last Edited on: 03-03-2024 20:40:23

Printed on : 04-03-2024 10:35 AM

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