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Application for SCHOOL : For Class XI (Art)

SESSION-2024
Application Id:
BHU0302789105

1. Personal Information:
Name: VISHWAJIT KUMAR Date of Birth: 10 July 2009
Registered Mobile No. : 9523216760 Registered Email Id : vishwajeet2434@gmail.com
Gender: Male Category : OBC-NCL
Physically Challenged: No NCC Certificate: No
Father's Name: Daya Shankar Kumar Mother's Name: Geeta Devi
BHU Employee Ward: No Employee Id: N/A

2. Permanent Address:
Address Line 1: Dihra, Narsandha, Chandi
PIN Code: 803110 State: B
Alternate Mobile No: 6203965897

3. Communication Address:
Address Line 1: Dihra, Narsandha, Chandi
PIN Code: 803110 State: B
Alternate Mobile No: 6203965897

4. Bank Details:
Bank Name: State Bank Of India Branch Name: Chandi
Bank A/C No: 36039969441 Bank IFSC Code: SBIN00163
Account Holder Name: Vishwajeet Kumar

5. Payment Details:
Order ID: order_Nnona0tki6wIAW Payment Date Time: 18-03-2024 05:59 PM
Amount: 800 Payment ID: pay_NnonrteEcCtzoC

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 the
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 f
disciplinary action be also taken against me.

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

Date: 18-03-2024, Application Last Edited on: 18-03-2024 17:58:43

Printed on : 18-03-2024 06:00 PM

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