Hostel Allocation Form

Application No: 19011191

Applicant Details
Admitted School Programme Dynamic Application
JGLS B.A. LL.B 1
Name Admitted to no (official use)
Student Id JGU Email ID Title MISS
First Name NIDHI Middle Name Last Name JHA
Date of Birth 11/04/2000 Mobile Number +91-9122039323 Email Address NIDHIJHACL@GMAIL.COM
Height (in cms) 165.1 Religion HINDUISM Gender FEMALE
Any Physical
Weight (in KG) 46 Blood Group A+ NO
Disability ?

Are you taking

Professional
Upload Your Photograph
Please Mention :
counselling for NO
psychological well
being?

Please Share Details

Any medical
condition that
requires NO
continuous
observation

Please Share Details

Address for Correspondence

Country INDIA State JHARKHAND District EAST SINGHBHUM
HOUSE NO. 14 RAAIN BASERA
City JAMSHEDPUR Address Line 1 Address Line 2 S-TYPE ADITYAPUR
COLONY
Is Permanent
Address Same As
Pincode 831013 YES
Address For
Communication?
Permanent Address
Country INDIA State JHARKHAND District EAST SINGHBHUM
HOUSE NO. 14 RAAIN BASERA
City JAMSHEDPUR Address Line 1 Address Line 2 S-TYPE ADITYAPUR
COLONY
Pincode 831013

Parent's Details
Parent Details PARENTS
Parent 1 Details
Name MAMTA JHA Mobile Number +91-9122039323 Email Address MAMTAJHA1108@GMAIL.COM
Relationship with
MOTHER Occupation HOME MAKER Company Name
Applicant
Annual Income (In Upload Your Parent 1
Designation Photograph :
Lakhs)
Parent 2 Details
Name SUNIL KUMAR JHA Mobile Number +91-7870424293 Email Address JHASUNIL1108@GMAIL.COM
Relationship with
FATHER Occupation BUSINESS Designation PARTNER
Applicant
Annual Income (In Upload Your Parent 2
20 LAKHS Photograph :
Lakhs)

Visitor's Details
Would you like to
Number of Visitor
fill the visitors NO
details to be filled?
data?
Visitor 1
Full Name Mobile Number Email Address
Country State District
City Address Line 1 Address Line 2
Pincode Upload Photograph :

Visitor 2
Full Name Mobile Number Email Address
Country State District
City Address Line 1 Address Line 2
Pincode Upload Photograph :

Visitor 3
Full Name Mobile Number Email Address
Country State District
City Address Line 1 Address Line 2
Pincode Upload Photograph :

Visitor 4
Full Name Mobile Number Email Address
Country State District
City Address Line 1 Address Line 2
Pincode Upload Photograph :