17/02/2015

ApplicationForm(INDIANCOUNCILOFAGRICULTURALRESEARCH)

NOTE::PleaseverifythatFormNo.willbesameonallthepageslikeAddress
Slip,MainForm,AdmitCardandChallan(PaymentSlip).
AddressSlip(TobepastedonenvelopebyApplicant)

ONLINEAPPLICATIONFORMFOR(AIEEAUG2015)
BySpeed/RegisteredPost
To,
FormNo:661400

From::GOPU
KRISHNAN.S(661400)
443,VALENCHERI,
MORAYUR,MALAPPURAM,
Kerala673642

http://icarexam.net/PrintOutForm.php

TheControllerofExaminations(Agril.
Edn.),
ExamCell,EducationDivision,ICAR,
RoomNo.216,KrishiAnusandhan
BhavanII,
Pusa,NewDelhi110012

1/3

17/02/2015

ApplicationForm(INDIANCOUNCILOFAGRICULTURALRESEARCH)

FeeRs.525DepositedinSyndicateBank(BranchCodeBIC:4602)on16/02/2015vide107

INDIANCOUNCILOFAGRICULTURALRESEARCH
ICAR's20thAllIndiaEntranceExaminationforAdmissiontoBachelorDegreeProgrammesand
AwardofNationalTalentScholarship(AIEEAUG2015)inAgricultureandAlliedSubjectsother
thanVeterinaryScienceforthe

UG

ACADEMICSESSION20152016
Candidate'sName:
Father'sName:
Mother'sName:
DateofBirth:

GOPUKRISHNAN.S
SASIKUMAR.V.V
LATHIKA.K
29/09/1997

FormNo.

661400

ExamCityCenter: 48KOZHIKODE
SchoolBoard:
StateofDomicile:

KeralaBoardofPublicExaminations
Kerala

SubjectGroup:

Biology

Stream:

AAgriculture/
Biology

Category:
Phone:
Nationality:

General
04832775214
INDIAN

Sex:
Mobile:

Male
9020051140

Placeof
Residence:

Village

PaperMedium:
TypeofInstitution:

ENGLISH
Private
ClassX:
ClassXII:

100%

Percentageoftotalaggregatemarksobtained:

SignatureofStudent

LeftThumbImpression
SubjectTakeninClassXII:
Yr.ofPassing/appearingclassXII:
PercentagemarksinClassXIIinPCMB:

1.Physics2.Chemistry3.Biology4.Maths5.English6.Hindi
2015

PercentagemarksinEnglish
Address:
443,VALENCHERI,MORAYUR,MALAPPURAM,Kerala673642
ModeofPayment:
ThroughChallan
PleaseWriteunderlinedpartoftheDeclarationGivenBelowInownHandwriting

Declaration: I hereby solemnly affirm that all the particulars stated by me in this Application are true and correct. I have not concealed any information.
However,ifanyinformationfurnishedhereinisfraudulent,incorrectoruntrue,IunderstandthatIamliabletocriminalprosecutionandIalsoagreeto
foregomyadmission.Furtherthattheselectionandadmissiontothecourseisliabletobecancelledatanytimeduringtheentiredegreeprogram.Iagreeto
abide by the rules and regulations governing the examination as contained in the Information Bulletin, which I have duly studied and understood
thoroughly.

Signatureofthecandidateinrunninghand(NOTINCAPITAL
LETTERS)
Ihavefullyreadtheinformationfurnishedbymyson/daughter/wardandaffirmthatitistrueandifitisfoundatanystagethattheinformationis
fradulent,Iamliabletocriminalprosecution.
Date:

Date............................

http://icarexam.net/PrintOutForm.php

Place........

SignatureofFather/Mother/Guardian(*IfFatherandMothernot
alive)

2/3

17/02/2015

ApplicationForm(INDIANCOUNCILOFAGRICULTURALRESEARCH)

OFFICECOPY
ADMITCARD
(TobesubmittedalongwithApplicationpositively)

ApplicationFormNo.

661400

INDIANCOUNCILOFAGRICULTURALRESEARCH
KrishiAnusandhanBhavanII,Pusa,NewDelhi110012
20 th ALL INDIA ENTRANCE EXAMINATION FOR ADMISSION TO BACHELOR DEGREE PROGRAMMES IN
AGRICULTUREANDALLIEDSCIENCESUBJECTS(OTHERTHANVETERINARYSCIENCES)ANDAWARDOF
NATIONALTALENTSCHOLARSHIPFORTHEACADEMICSESSION201516
RollNo:

STREAM: AAgriculture/
Biology

NameandAddressofCandidate
GOPUKRISHNAN.S
443
VALENCHERI,MORAYUR
MALAPPURAM,Kerala

OptionalSubject:..................................

DateofExam:11.04.2015(Saturday)
Duration:10:00AMto12:30PM(2hours)
ReportingTime:09:30AM
NoEntryAfter:10:30AM
CannotLeaveBefore:12:30PM

NameoftheCityofExamination:

KOZHIKODE

Venue:

ThumbImpression

SignatureoftheCandidate

Pasteyourrecentpassport
sizecolorphotograph
(3.5x4.5cm)
Tobeattestedby
Principal/GazettedOfficer

ControllerofExams(Agril.
Edn)

CANDIDATECOPY
(TOBERETAINEDBYTHECANDIDATE)
ADMITCARD
ApplicationFormNo.

661400

INDIANCOUNCILOFAGRICULTURALRESEARCH
KrishiAnusandhanBhavanII,Pusa,NewDelhi110012
20 th ALL INDIA ENTRANCE EXAMINATION FOR ADMISSION TO BACHELOR DEGREE PROGRAMMES IN
AGRICULTUREANDALLIEDSCIENCESUBJECTS(OTHERTHANVETERINARYSCIENCES)ANDAWARDOF
NATIONALTALENTSCHOLARSHIPFORTHEACADEMICSESSION201516
RollNo:

STREAM: AAgriculture/
Biology

NameandAddressofCandidate
GOPUKRISHNAN.S
443
VALENCHERI,MORAYUR
MALAPPURAM,Kerala

OptionalSubject:..................................

DateofExam:11.04.2015(Saturday)
Duration:10:00AMto12:30PM(2hours)
ReportingTime:09:30AM
NoEntryAfter:10:30AM
CannotLeaveBefore:12:30PM

NameoftheCityofExamination:

KOZHIKODE

Venue:

ThumbImpression

SignatureoftheCandidate

http://icarexam.net/PrintOutForm.php

Pasteyourrecentpassport
sizecolorphotograph
(3.5x4.5cm)
Tobeattestedby
Principal/GazettedOfficer

ControllerofExams(Agril.
Edn)

3/3