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    Gend

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    Akash Banerjee
    This document is an acknowledgement page for Soumyadip Biswas' application to the Joint Entrance Examination (Main) - 2018. It provides personal details of the candidate such as name, date of birth, category, school details. It also lists the examination details including the date chosen for the computer-based exam and payment details. Key information includes Soumyadip applying for JEE(Main) Paper 1 for B.E./B.Tech. and choosing April 15, 2018 as the date to take the computer-based exam.

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    Gend

    Uploaded by

    Akash Banerjee
    24 views1 page
    This document is an acknowledgement page for Soumyadip Biswas' application to the Joint Entrance Examination (Main) - 2018. It provides personal details of the candidate such as name, date of birth, category, school details. It also lists the examination details including the date chosen for the computer-based exam and payment details. Key information includes Soumyadip applying for JEE(Main) Paper 1 for B.E./B.Tech. and choosing April 15, 2018 as the date to take the computer-based exam.

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    This document is an acknowledgement page for Soumyadip Biswas' application to the Joint Entrance Examination (Main) - 2018. It provides personal details of the candidate such as name, date of birth, category, school details. It also lists the examination details including the date chosen for the computer-based exam and payment details. Key information includes Soumyadip applying for JEE(Main) Paper 1 for B.E./B.Tech. and choosing April 15, 2018 as the date to take the computer-based exam.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    24 views1 page

    Gend

    Uploaded by

    Akash Banerjee
    This document is an acknowledgement page for Soumyadip Biswas' application to the Joint Entrance Examination (Main) - 2018. It provides personal details of the candidate such as name, date of birth, category, school details. It also lists the examination details including the date chosen for the computer-based exam and payment details. Key information includes Soumyadip applying for JEE(Main) Paper 1 for B.E./B.Tech. and choosing April 15, 2018 as the date to take the computer-based exam.

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    Joint Entrance Examination (Main) - 2018

    CENTRAL BOARD OF SECONDARY EDUCATION


    ACKNOWLEDGEMENT PAGE

    Application No. 81038627


    DO NOT SEND THIS PAGE TO CBSE.
    CANDIDATES ARE REQUESTED TO RETAIN THE PRINTOUT OF ACKNOWLEDGEMENT PAGE FOR FUTURE REFERENCE.

    Personal Details
    Name: SOUMYADIP BISWAS Date of Birth: 05/02/2000
    Mother's Name: GOURI BISWAS Category SC
    Caste Name Rajbanshi Father's Name: TARAK NATH BISWAS
    Person with Disability(PwD): NO State of Eligibility: WEST BENGAL
    Percentage of Disability: -- Gender: MALE
    Are you Diabetic :: NO Nationality: INDIAN
    Place of Residence: URBAN You need scribe/reader ?: NO

    Examination Details
    Applying For: JEE(Main) Paper - 1 (B.E./B.Tech.) Only
    Mode of Examination: COMPUTER BASED EXAMINATION Question Paper Medium: ENGLISH
    Choice of Online Exam Centre: KOLKATA

    Academic Details
    Year of passing class 10th: 2016 Place of 12th class schooling: TOWN
    Year of Passing or Appearing class 12th/Qualifying Exam: 2018 Type of Institution of Class 12th/Qualifying Exam: PRIVATE
    School Board of class 12th/Qualifying Exam: COUNCIL FOR THE INDIAN SCHOOL CERTIFICATE EXAMINATIONS
    Name of the Qualifying Examination passed / appearing: The final examination of the 10+2 system, conducted by any recognized central/ state Board, such as Central
    Board of Secondary Education, New Delhi; Council for the Indian School Certificate Examinations, New Delhi;
    etc.
    Percentage of Marks in Class 12th/Qualifying Exam: -- Roll No. of Class 12th/Qualifying Exam: --
    Appeared/Appearing for Improvement of Class NO Mode of preperation: INDIVIDUAL
    12th/Qualifying Exam: TUITION
    Roll Number of Class 12th/Qualifying Examination of
    Improvement Examination:
    Name and Address of the School/College from where Douglas Memorial Higher Secondary School 52, Barrack Road, Barrackpore, Kolkata - 700120
    passed/appearing:

    Candidate's Mailing Address


    Country: India State: WEST BENGAL
    District: NORTH 24 PARGANAS Address: 13, Kaibartapara, Titagarh, Khardah
    Locality: Khardah City/Town/Village: Kolkata
    Pin Code: 700117 Email Address: sou*******@gmail.com
    Mobile Number: 974****073

    Guardian Details
    Qualification Occupation Annual Income
    Father's/Guardian's: MATRICULATE GOVERNMENT SERVICE RS. 300001 -400000
    Mother's: GRADUATE PRIVATE SERVICE UPTO 100000

    Payment Details
    Provider Name: HDFC Bank Payment Gateway Payment Mode: Electronic Payment Gateway
    Fee Type: Examination Fee Transaction Amount: 250 /-
    Transaction ID: LHMP5924239042 Date of Transaction: 30-12-2017 00:16:19

    Selected Date for Computer Based Examination of Paper-1


    Your selected date for Computer Based Examination: 15/04/2018
    DECLARATION
    I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. I have read and understood the JEE procedures for both
    JEE(Main) and JEE(Advanced) - 2018. I shall abide by the terms and conditions thereon.

    Images Uploaded by Candidate


    Candidate Photograph Candidate Signature Parent/Guardian Signature

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