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JEE (Main) AcknowledgementPage

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Joint Entrance Examination (Main) - 2015

CENTRAL BOARD OF SECONDARY EDUCATION


ACKNOWLEDGEMENT PAGE

Application No.

50390574
DO NOT SEND THIS PAGE TO CBSE.

CANDIDATES ARE REQUESTED TO RETAIN THE PRINTOUT OF ACKNOWLEDGEMENT PAGE FOR FUTURE REFERENCE.

Personal Details
Name:

BHUVNESH ARYA

Date of Birth:

08/05/1996

Mother's Name:

SUSHILA KANSARA

Category

OBC- NCL (CENTRAL LIST)

Father's Name:

KAMAL KISHORE ARYA

Person with Disability(PwD):

NO

State of Eligibility:

RAJASTHAN

Percentage of Disability:

--

Gender:

MALE

Are you the only child?:

NO

Nationality:

INDIAN

Place of Residence:

URBAN

Aadhaar Number (UIDAI):

--

You need scribe/reader ?:

NO

Examination Details
Applying For:

JEE(Main) Paper - 1 and Paper - 2 Both

Examination Mode (B.Tech.):

PEN AND PAPER BASED EXAMINATION

Examination Mode (B.Arch.):

PEN AND PAPER BASED EXAMINATION

Question Paper Medium:

ENGLISH

1st Choice of Exam Centre:

JODHPUR

2nd Choice of Exam Centre:

JAIPUR

3rd Choice of Exam Centre:

BIKANER

4th Choice of Exam Centre:

AJMER

Academic Details
Year of passing class 10th:

2012

Year of Passing or Appearing class 12th/Qualifying Exam: 2014

Place of 12th class schooling:

CITY

Type of Institution of Class 12th/Qualifying Exam:

PRIVATE

School Board of class 12th/Qualifying Exam:

RAJASTHAN BOARD OF SECONDARY EDUCATION

Name of the Qualifying Examination passed / appearing:

Any Public School/ Board/ University examination in India or in any foreign country recognized as equivalent to
the 10+2 system by the Association of Indian Universities (AIU).

Percentage of Marks in Class 12th/Qualifying Exam:

74.20

Roll No. of Class 12th/Qualifying Exam:

1592314

Appeared/Appearing for Improvement of Class


12th/Qualifying Exam:

NO

Mode of preperation:

COACHING

Roll Number of Class 12th/Qualifying Examination of


Improvement Examination:
Name and Address of the School/College from where
passed/appearing:

SHRI MAHESHWARI SENIOR SECONDARY SCHOOL OPPOSITE UMAID HOSPITAL , GEETA BHAWAN
ROAD , SIWANCHI GATE , JODHPUR

Candidate's Mailing Address


Address:

OPPOSITE A-1 KASHIDA CENTRE , FARASON KA


BANGLA

Locality:

MOTI CHOWK

City/Town/Village:

JODHPUR

District:

JODHPUR

State:

RAJASTHAN

Pin Code:

342001

Email Address:

aryabhuv@gmail.com

Mobile Number:

9680919046

Land Line Number:

02912631095

Guardian Details
Qualification

Occupation

Annual Income

Father's/Guardian's:

--

--

--

Mother's:

--

--

--

Payment Mode:

Credit / Debit Card

Transaction ID:

ASMP3567897488

Exam Fee:

1800 /-

Date of Transaction:

25-11-2014 08:08:32

Card Type:

VISA/Master Card

--

--

Payment Details

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) - 2015. I shall abide by the terms and conditions thereon.

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Signature

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