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    Amity Application Form

    Uploaded by

    mohdtalib.ibi

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Amity Application Form

    Uploaded by

    mohdtalib.ibi
    22 views3 pages

    Original Title

    AMITY APPLICATION FORM

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
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    Download as pdf or txt
    22 views3 pages

    Amity Application Form

    Uploaded by

    mohdtalib.ibi

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    You are on page 1of 3

    MOHD.

    TALIB Form No : 12420968


    Transaction Number:
    MOHDTALIB.IBI@GMAIL.COM 451410112414
    +91 9643661788 Date: 27 May 2024
    B.Tech (Mechanical Engineering) Campus : Noida

    LATERAL DETAILS

    Enrollment / Admission year of previous


    : 2023
    Institution / University
    Semester Passed : 7
    Semester To Join : 3

    PERSONAL DETAILS

    Gender : Male
    Category :
    Date Of Birth : 29/11/2002
    Nationality : Indian
    Passport : No

    Correspondence Address
    Permanent Address
    For all communication related to your admission.
    A-12/1, OPPO. DHRUV HOSPITAL, GARIMA GARDEN, PASONDA, SAHIBABAD A-12/1, OPPO. DHRUV HOSPITAL, GARIMA GARDEN, PASONDA, SAHIBABAD
    Country :INDIA Country :INDIA
    Sate :UTTAR PRADESH Sate :UTTAR PRADESH
    City :SAHIBABAD City :SAHIBABAD
    PinCode :201005 PinCode :201005

    Admission Category : NS
    Hostel Accommodation : No

    Education Details
    It is mandatory to fill all details of educational qualification (as applicable) from class X onwards till last completed semester / year. If the system of
    marking of your school / college is on grading pattern, convert grade into marks as applicable and fill in the respective columns. In absence of complete
    information, form will be rejected.
    Class X

    Board Type : CBSE


    Board Name : 0
    Board Roll No : 5398380
    Passing Year : 2019
    Aggregate Percentage : 61.60
    School Code : 59008
    Mark Type : Marks

    Class XII

    Board Type : CBSE


    Passing Year : 2024
    Medium of instruction : English
    School Name : INDO GERMAN TOOL ROOM
    City : INDORE
    Pin / Zip Code : 110007
    XII Board Name : CBSE
    Board Roll No : 12634
    Board Admit Card No : 12634
    XII Results Declared : Yes
    Marks

    Class XII Board Result Details (Provide details of all subjects as in class XII marksheet)

    Mark Type : Sno. Subject Marks Marks Out of


    1 ENGLISH 53 100
    2 MATHEMATICS 63 100
    Page 1 of 3 27 May 2024
    3 PHYSICS 50 100
    4 CHEMISTRY 41 100

    Page 2 of 3 27 May 2024


    Prequalifying Test

    For Engineering Programs :

    Family Information

    Relationship Father Mother


    Name MUSTKEEM SHAKILA KHATOON
    Age 47 43
    Email mohdtalib.ibi@gmail.com
    Mobile +91 9350139671 +91 9310574260
    Qualification School Level School Level
    profession
    Organisation
    Designation
    Employment Category SELF-EMPLOYED HOMEMAKER
    Country of Residence INDIA INDIA
    Family at Amity - Any of your associated no
    with Amity

    Other Information

    Aadhaar Card No : 229760533266


    Do you suffer from any chronic ailment : No
    Have you ever been suspended, dismissed or
    No
    put on academic probation or warning at any :
    school or college?

    Extra Curricular

    Awards / Achievements Name : No

    Employment

    Work Experience : No

    Previously Applied

    Have you previously applied to Amity? : No

    Page 3 of 3 27 May 2024

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