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15147249

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STEP1(Candidate Details)
STEP2(Upload Files)
STEP3(Pay your Fee)
STEP4(Confirmation)

Personal Detail

NAME OF CANDIDATE
SHAILENDR

FATHER'S NAME
PREM PAL

MOTHER'S NAME
MOONGA D

DATE OF BIRTH
30/09/1997

REGISTRATION NO. / APPLICATION ID

10114499

MOBILE NO.
989124438

GENDER
Male

NATIONALITY
INDIAN

PARENT'S DOMICILE
U.P.

STATE / UT (IF NON UP DOMICILE)

UTTAR PRADESH

DISTRICT (IF NON UP DOMICILE)

Qualifying Detail

QUALIYFYING EXAM STATUS

PASSED

QUALIFYING EXAMINATION
INTERMEDIATE

EXAMINATION PASSED/APPEARED FROM

U.P.

YEAR OF PASSING
2014

MARKS OBTAINED
426

MAXIMUM MARKS
500

Category Information

CATEGORY
UPBC

SUB CATEGORY
NOT APPLICABLE

RURAL WEIGHTAGE CLAIMED

NOT APPLICABLE

Subject In Qualifying Examination 10 + 2

Subject

BIO-TECHNOLOGY

TECHINICAL VOCATION SUBJECT

COMPUTER SCIENCE

Select Subject(s)

ENGINEERING DRAWING

PHYSICS

BIOLOGY

AGRICULTURE GROUP (AG-I,AG-II,AG-III)

MATHEMATICS

CHEMISTRY

ANY DISIPLINE (FOR BHMCT/BFAD/BFA)

Eligible Courses

Select Course(s)

Eligible Paper(s)

Paper(s)

Mathematics, Physics and Chemistry

Choice of Cities for Examination

FIRST CHOICE
---Select---

SECOND CHOICE
---Select---

THIRD CHOICE
---Select---

Communication Details

PRESENT ADDRESS

PINCODE

PERMANENT
ADDRESS

Same as Present
Address

PINCODE

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Payment History

02-Mar-2015 [04:20 PM IST]

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Payment done successfully on -- : IST

Payment Details:
SBCollect Reference Number

DU12234642

Category

Male - General and Male - OBC

Application Number

15147249

Name of candidate

SHAILENDRA

Date of Birth

30/9/1997

Contact number

7351964188

Application Fee

700

Transaction Charge

INR 16.85

Total Amount

INR 716.85

Remarks
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Your payment of INR 716.85 has been made successfully.

Your Transaction Reference Number is 46761694
Kindly wait while we pass on your payment confirmation....
Application# 15147249*
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NEST 2015 Online Form Summary Page

Application number: 15147249

Name:

SHAILENDRA

Category:

OBC

Physically Disabled? (PD):

NO

Gender:

Male

Date of Birth:

1997-09-30 [yyyy-mm-dd]

State of Domicile:

Uttar Pradesh (UP)

Address for
Correspondence:

NEAR BRIJWASI SCHOOL EKTA NAGAR

PILIBHIT U.P

Contacts:

Test Centre Choice:

10 Academic Record:

PIN Code:

262001

Contact#:

7351964188

e-mail ID:

gang30shailendra@gmail.com

First:

Delhi-South (DL)

Second:

Delhi-East (DL)

Class

Year

Board/Council

Percentage

10th/ Equiv.

2012

CBSE

89.30

12th/ Equiv.

2014

CBSE

85.20

11 Father's Name:

PREM PAL

12 Details of Guardian:

Name:

PREM PAL

Contact #:

9897010618

Relationship:

FATHER

Amount:

700 INR (Rupees Seven hundred only)

SBCollect Ref#:

DU12234642

Payment date:

02-Mar 2015

13 Payment Details:
Mode: Online

Declaration by the candidate

I hereby declare that all the particulars stated in the application are true to the best of my knowledge and belief. I have

read the information brochure and I shall abide by the terms and conditions therein.
Yes, I have read the brochure and I agree to sign the declaration.

Last saved : 2015, 02 Mar 16:23

Signature of the candidate (as uploaded)

Click to Print
If photo & signature do not appear clearly in their designated places, the application form may
not be accepted.

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Reprint Remittance Form
Payment History

02-Mar-2015 [04:20 PM IST]

State Bank Collect

Payment done successfully on -- : IST

Payment Details:
SBCollect Reference Number

DU12234642

Category

Male - General and Male - OBC

Application Number

15147249

Name of candidate

SHAILENDRA

Date of Birth

30/9/1997

Contact number

7351964188

Application Fee

700

Transaction Charge

INR 16.85

Total Amount

INR 716.85

Remarks
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NISER-NEST
NISER, INSTITUTE OF PHYSICS
CAMPUS,SACHIVALYA MARG, PO-

Date:

SAINIK SCHOOL, BHUBANESWAR, ,

BHUBANESWAR-751005
e-Receipt for State Bank Collect Payment
SBCollect Reference Number

DU12234642

Category

Male - General and Male - OBC

Application Number

15147249

Name of candidate

SHAILENDRA

Date of Birth

30/9/1997

Contact number

7351964188

Application Fee

700

Transaction charge

16.85

Total Amount (In Figures)

716.85

Total Amount (In Words)

Rupees Seven Hundred Sixteen and

Paise Eighty Five Only

Remarks

Notification1

E-receipt generated after successful

payment may be printed and retained for
future reference.

Notification2

Examination fee, once deposited, would

not be refunded.

Click Here to Print

CENTRAL BOARD OF

ADMIT CARD FOR JOINT ENT

Center
Number:

139060

Center of
N K BAGRODIA PUBLIC SCHOOL
Examination : , AHINSA MARG, SECTOR 9, ROHINI,
DELHI/NEW DELHI, DELHI, 110085
Candidate's
Name :
Father's
Name :

SHAILENDRA

Date of

04/04/2
Question

EN

PREM PAL

Candidate Mailing Address

EKTA NAGAR COLONY NEAR BRIJWASHI
Address : SCHOOL

Locality:

PILIBHIT

City / Town /
Village :

PILIBHIT

District :

PILIBHIT

State :
Pin Code :

Ca

OBC- NC
LIS

UTTAR PRADESH
262001

Email
address :

gang30shailendra@gmail.com

Mobile
number :

7351964188

DIRECTIONS FOR CAN

1.

Please check in the Admit Card carefully for your Name, Course, Date
Paper Medium. In case of any discrepancy, communicate to the CBSE imm
2.
Candidates shall be present at the examination Centre by 9 AM(IST) f
minutes before the commencement of the examination.

3.

No Candidate in any case will be allowed to enter at the Examination

paper.
4.
No Candidate without Admit Card shall be allowed to sit in the exami
5.
Candidates must preserve the Admit Card till the allotment of seat in C
6.
No Candidate shall be allowed to leave the Examination Hall before th
Sheet to the Invigilator concerned.
7.
Candidates should check and ensure that the Test Booklet contains as
8.
Candidate shall not remove any page(s) from the Test booklet and if a
he/she may be liable for criminal action.
9.
Candidates should bring good quality blue/black ball point pens for th
PROHIBITED.
10.
Candidates should use blue/black ball point pen only to write particula
darkening the circles of response.
11.
Calculators,Log tables,Calculating devices,Communication Devices li
are not allowed in the Exam Hall.
12.
If a candidate is found in possession of Cellular Phone/Paper/Docupen
candidature will be cancelled.
13.
Candidates must follow the instructions strictly as contained in the Inf
14.
The Admit Card is issued provisionally to the candidate subject to his/
15.
On completion of the test, candidate must handover the Answer Sheet
only the Test Booklet.
16.
For Aptitude Test Paper 2, the candidate must bring there own Geome
The Candidates are NOT allowed to use water colours on Drawing Sheet.
17.
For detailed guidelines and instructions regarding examination, p
JEE(Main)-2015.
18.
The Physically Challenged(PwD) Candidates must carry a copy of
apendix 10 of the Information Bulletin.

Application form for admission to First

Engineering 2015-16

ELIGIBILITY CRITERIA FOR ADMIS

Army Institute of Technology is ONLY for the f
CHILDREN OF ELIGIBLE SERVING
ELIGIBLE EX-ARMY PERSONNEL & WAR
Candidates are required to submit the relev
eligibility as per Para 17 of Prospectus 2015

IMPORTANT NOTICE:

LAST DATE FOR FILLING ONLINE APPLICATION: APR

PLEASE DOWNLOAD PROSPECTUS AND READ THE R
FILLING UP APPLICATION.

PART I
1. Roll Number of JEE (Main) 2015 (p
entered the correct 8 digit ROLL NUMBER ap
Admit Card.) Click here to view a sample adm
13930409

2. Personal Details:
a. Applicant`s Name (In First Name - Mi
SHAILENDR

b. Gender: *
Male Female
c. Date of Birth: *

30

Month of Birth: *
September

Year of Birth: *
1997

d. Place of Birth:
KANAKOR

e. Age as on 01 Jul, 2015 (For eg: 22 Yea

17YEARS 0

3. Father`s Name (In First Name - Middl

PREM PAL

4. Mother`s Name (In First Name - Midd

MOONGA D

5 a. Rank of the Father/Mother as applic

etc) *
NK

b. Category
OR

6 a. Year of appearing / passing the quali

equivalent
2014

b. Have you passed the qualifying exami

and Mathematics taken together? *
Yes

c. If YES,
Total Marks
obtained in

To
m Ma

Physics,
Chemistry and
Mathematics
1

279

Physi
Chem
Mathe

7 a. Are you a Citizen of India? *

Yes No

b. Are you a person of Indian origin mig

Yes No

8 a. Is your Father / Mother serving in In

at Para 17) *
Yes

b. If Yes, then are/were they serving in In

employed person with minimum 10 years cont
Regular

9. Is your father/mother retired/released

(Upload Certificate 1 at Para 17)
No

10. Are you a Step child/adopted child o

certificate 2 at Para 17) *
Yes No

11. Does your father/mother belong to th

at para 17)
No

12. Are you a Ward of War Widow? ( Up

Yes

No

13 a. Is your father/mother a Gallantry A

document at Para 18) *
Yes No
b. If Yes,
Mention name of the Award
c. Year of Award
14 a. Address of Correspondence *
Street Address
KANAKOR

Address Line 2
City
PILIBHIT

State / Province / Region

UTTAR PRA

Postal / Zip Code

262001

Country
b. Email
gang30sha

c. Your Mobile Number

989124438

d. Father/Mother's Mobile Number

989701061

e. Telephone Number
Tel. Number

Part II
15. Checklist (Submit the following orig
the time of admission. Refer to Prospectus for
Appendix 'A', 'B' and 'C')
Photostat copy of JEE (Main) Hall ticke
Gallantry Award winning Category
Copy of Mark sheet (10 +2)

Certificate 1/2/

Proof of War widows (Appendix A)

(Appendix B)

Proof of

Addre

Willingness Certificate (Ap

Pension Pay Order

16. Please Upload your recent passport s
(ONLY in .jpg format)
Uploaded File Name :
shailendra'

17. File Upload 1: Mandatory certificate

applicable.Refer prospectus for proforma.File
"Certificate 2" or "Certificate 3"(only in .pdf f
Uploaded File Name :

18. File Upload 2: Proof of Gallantry Aw

whichever is applicable.Refer prospectus for p
"Award", "War widow" or "PPO" (only in .pdf

Uploaded File Name :

N.B:
1. If you are not able to upload the mandatory documents
copies of the required documents to admission@aitpune.e
Mention your application number in every email that you
2. Please check your email regularly for any corresponden

*Application number is a system generated number

submission of form online along with application fee.

For any technical

email support@nopaperfo

Success! Your application has been received.

Application No.: AIT/15_85 | Payment Transaction ID: 147007021

Your application has been submitted successfully. The admissions committee will review your application and you will be informed of t
For future reference and any correspondence, please ensure that you mention your application number printed above.

For any admissions-related questions, please email us at admission@aitpune.edu.in. Quote the application number for easy retrieval of your fi

contact support@nopaperforms.com. This also serves as an acknowledgement that your application was received by the institution. You can pr
acknowledgement receipt for your own records.

support@nopaperforms.com

Application Form For Admission / SET- 2015

Save & Print Welcome SHAILENDRA Logout
Admission/ SET-2015 : Confirmation page for application Number : (For
Office Use Only)
Confirmation Page- Admission / SET 2015 Mode of admission For BTech Scholarship
Application No 150 385
You have successfully submitted Application On-line. Kindly take two printout of this page. Paste your
two recent photograph and sign in the specified Box. Send one of this form along with Demand Draft
to "NIAERM, A-180, ROAD NO.-4, L.NO.-10,NEAR MADHUBAN HOTEL, OPP. INDIRA GANDHI
AIRPORT, NH-8, MAHIPALPUR, NEW DELHI- 110037" to reach latest by 31-march-2015.

Candidate's Name : SHAILENDRA

Date of Birth : 30/09/1997
Mother's Name : MOONGA DEVI
Gender : MALE
Father's Name PREM PAL
Category : OBC- NCL (CENTRAL LIST)
State of Eligibility : UTTAR PRADESH
Nationality : INDIAN
School Board of Class 12th/Qualifying Exam : CENTRAL BOARD OF SECONDARY
EDUCATION
Year of Passing Class 10th or its Equivalent : 2012
Passing Year 12th/Qualifying Exam2012

Address NEAR BRIJWASI SCHOOL GALI NO.5 EKTA NAGAR PILIBHIT

District : PILIBHIT
State : UTTAR PRADESH
Email Id gang30shailendra@gmail.com
Pincode : 262001
Contact No 0735196418
Alternate Contact : 9891244380
Examination Center Delhi
DECLARATION
I hereby solemnly and sincerely affirm that all the particulars stated by me in this Application Form are true and Correct. I
have not concealed any Information. However, if any information furnished herein is found fraudulent, incorrect or untrue, I
understand that I will be liable to criminal Prosecution and I also agree to forego my Seat. Further that the selection and
admission to the course is liable to be cancelled. I agree to abide by the Rules and Regulation governing the Examination as
contained in the SET Information Bulletin available on website, which I have duly gone through.

Paste your recent

photo,attested with
principal/gazetted
Officer

Write Your Detail Here

Name :
__________________________________
Father Name :
____________________________
Address :
________________________________
_______________________________________
_
____________________ Pin :_______________

Paste your recent photo,

attested with
principal/gazetted
Officer

Detail of Demand Draft(write Registration No., Name and address at the

back of Demand Draft)
Draft No. : 420281.
Amount: 1000
Date of Issue: 15/12/2014
Bank Name : ANDHRA BANK
Left Hand Thumb
Impression

Signature of the Candidate (not in capital letter)

countersignature of parents
or guardians