Uttar Pradesh State Entrance Examination - 2016

Dr. A P J Abdul Kalam Technical University Uttar Pradesh, Lucknow

Confirmation Page

Application No.

6078353

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

Personal Details
Name:

GAURAV KAMBOJ

Date of Birth:

28-12-1997

Mother's Name:

SUSHMA KAMBOJ

Category:

UPBC

Father's Name:

SUNIL KUMAR KAMBOJ

Gender:

Male

Nationality:

Indian

Rural weightage claimed:

No

Aadhaar Number (UIDAI):

891225198913

Domicile:

UTTAR PRADESH

Qualifying examination passed/appeared

from college situated in:

UTTAR PRADESH

Subcategory:

Not Applicable

Course Apply Details

Applying For:

UG

Qualifying Examination:

DIPLOMA IN ENGG.

1st Choice of Exam Centre:

Aligarh(OMR Based Exam ( For Paper 1, 2, 3 & 2nd Choice of Exam Centre:
4 only) & Computer Based Test (For Paper 5, 6,7
&8 only))

3rd Choice of Exam Centre:

Bareilly(OMR Based Exam ( For Paper 1, 2, 3 &

4 only) & Computer Based Test (For Paper 5, 6,7
&8 only))

Moradabad(OMR Based Exam ( For Paper 1, 2,

3 & 4 only) & Computer Based Test (For Paper
5, 6,7 &8 only))

Educational Details
Qualification

Pass
Status

Course/Stream Name

Board/University Name

Year Of
Passing

Marks (%)

Roll No.

Institute Name, Address & Pincode

DIPLOMA IN
ENGG.

Passed

DIPLOMA IN ENGG.

OTHERS

2014

76.4

147293006337 GOVERNMENT POLYTECHNIC

RAMPUR, U.P.

Seeking Admission & Courses Applied For

Seeking Admission For:

SECOND YEAR

Courses Applied For 1st Year Admission:

2nd Year (Lateral Entry):

B.Tech. 2nd Year (For Diploma Holder In Engg.)

Paper(S) In Which You Wish To Appear :

Paper 6

Communication Details
Address:

COD COLONY JWALANAGER

City/Town/Village:

RAMPUR

District:

RAMPUR

State:

UTTAR PRADESH

Pin Code:

244901

Email Address:

gauravkamboj614@gmail.com

Mobile Number:

9760258156

Land Line Number:

8273264969

Fee Payment Details

Payment Mode:

Using Debit/Credit Card

Transaction ID:

FURP4353130362

Exam Fee:

1000 /-

Date of Transaction:

13-03-2016 22:52:50

Fee Submitted On:

13/03/2016
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 Board
procedures. I shall abide by the terms and conditions thereon.

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