COMPLETE APPLICATION FORM : JEE B.Ed.

- 2024

A - Registration Details
Registration Number BED202410073093
Candidate Name SUPRIYA
Candidate's Father Name MUNNU PRASAD
Candidate's Mother Name MANJU DEVI
Candidate's Date of Birth 05/Dec/1998
Email Address supriyasupriya061@gmail.com
Primary Mobile Number 7549344767

B - Personal Details
Gender Female Marital Status Married
Spouse Name Nishant Singh Nationality Indian
Category General Category Certificate Number
State Domicile Other than UP Is 10 From Up
Is 12 From Up Is UG From Up
Is Person with Disability No Disability Type
Disability Percentage Is Economically Weaker
Id Proof Others Id Proof No
Alternate Email nishant.bluesman@gmail.com Alternate Mobile Number 8447069554
Do you belong to non creamy layer ?

C - Communication Address
B-177 Block-B Sector-122 Noida Uttar Pradesh 201301

D - Permanent Address
Kharijama Chandhari Islampur Nalanda Bihar 801303

E - Opted Stream Details

Stream opted for B.Ed. Science Language Selected Hindi

F - SSC / 10th Std / Equivalent Details

Board Name Others
Marks Obtained 293 Maximum Marks 500
Year Of Passing 2013 Percentage 58.6
G - HSC / 12th Std / Equivalent Details
Board Name Others
Marks Obtained 315 Maximum Marks 500
Year Of Passing 2015 Percentage 63

H - Graduation Details
Is Graduation complete Pass Stream of Graduation Science/Engineering
Specified Stream Have you done BE/BTech No
Name of University Magadh University
Marks Obtained 577 Maximum Marks 800
Percentage 72.12 Year Of Passing 2018
Roll Number 1832213969 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 Gautam Buddha Nagar Center Choice 2 Ghaziabad Center Choice 3 Meerut
Center Choice 4 Ghazipur Center Choice 5 Agra

L - Payment Details
Payment Status Success Payment Date 29/Feb/2024
Transaction Number ZHMP1786338906 Receipt Number 20240229
Order Id BED20241007309320240229132041192 Total Amount 1400

M - Declaration
I understand that it is my responsibility to check the eligibility criterion and other conditions of the J.E.E. B.Ed. 2024 – 26. 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. 2024 – 26 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. 2024 – 26 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.