XAT 2011

XAT PP Form ‐ Online Payment  

Note: Please paste your photograph and put your signatures in space provided and send this form to XAT Office.
XAT ID: XAT447376
 
XAT 2011 

XAT ID :  XAT447376

Please Affix your latest

NAME OF THE CANDIDATE:  KOTAMRAJU SAI SRI
photograph here  
CHARAN

TEST CITY OF THE CANDIDATE :  Hyderabad  

   
Please sign here

PAYMENT DETAILS :     
Transaction ID : 19435 Dated : 23‐Nov‐2010 Amount : Rs.974.18
     
PERSONAL DETAILS :      
Name of the candidate :   KOTAMRAJU SAI SRI CHARAN  
Date of Birth:   12‐Apr‐1990  
Test City :   Hyderabad  
Mailing Address(valid upto 31 May 2011)    
H # 1‐9‐18/1/1 , RAMNAGAR ,    

City :  HYDERABAD State : Andhra Pradesh  

Pincode :  500048 Phone No: 9052919156  
Primary Email Id : enigmaicon@gmail.com    
     
I hereby certify that the information provided by me in this application as well
DECLARATION :
as in the online registration form,is accurate and complete .I also agree to
abide by the decision of the institute's authorities on all matters regarding this
 
application.
 Date : 

 
Signature of the
candidate: