Admission

Application ID 1131001168 2017-18

Session
Program B.Sc (Hons) Agriculture (6 Years Course B.Sc (Hons) Agriculture (6 Years
Name - (2+4) - Bawal Selected - (2+4) - Bawal
Applicant Application
Normal Complete
Type Status
Submitted
2017-04-30 16:37:25.0
Date &Time

Personal Details
Date of Birth (YY-MM-
Name of the Applicant Sania 2001-01-06 Gender Female
DD)
Email Id jrnarwal@gmail.com Mobile Number 9891810624 Religion Hindu
Category in which you want
SC
to Apply
Are you Physically
No PWD Type NA
Handicapped?
Father's Name Jagjeevan Ram Mother's Name Rani Devi

Address Details
Correspondence H. NO. 1546 GALI NO. 6 RAJEEV NAGAR OPP. AIR FORCE SCHOOL, Gurgaon, Gurgaon, Haryana,
Address India - 122001
H. NO. 1546 GALI NO. 6 RAJEEV NAGAR OPP. AIR FORCE SCHOOL, Gurgaon, Gurgaon, Haryana,
Permanent Address India - 122001
Nationality India
Domicile State Haryana

Educational Details
Max Marks
University/Board College/School Year Roll No % Subject
Marks Obtained
HINDI, SCIENCE,
Delhi-Central Board of OUR LADY OF
ENGLISH,
Secondary Education FATIMA CONVENT 2017 2129837 0 0 0.0
MATHEMATICS, SOCIAL
(CBSE) SEC SCHOOL
SCIENCE

Additional Personal Details

You are Depend on : Father
Guardian Name : NA
Guardian Address : NA
Occupation : INR 3,00,001 to INR 5,00,000
Annual Income : PRIVATE SERVICE
Is Debarred/Rusticated? : No
Reason for Debarred : NA
Debarred Period : NA
Previous Student : No
Admission No : NA
Admission Period : NA
Migration Certificate Issued? : Yes
Name of The Institute Where Sought Admission : NA
Sports Quota Category : No
Applicable for LDV : No
Land Donated village(LDV) name : NA
Freedom Fighter : No

Payment Details
Fee/Payment Amount 250 Transaction Status Success
Transaction Id 147110347 Payment Date 2017-04-30 16:37:25.0
Images

Candidate's Candidate's Thumb

Signature Impression

Declaration
I hereby affirm that the information given by me in this admission form is complete and true to the best of my knowledge and
belief and nothing has been concealed and that I have made thisapplication with the consent and approval of my
parent/guardian. In the event of my being admitted to one of the constituent Colleges, I undertake to abide by disciplinary
and other rules and regulationsof the College and the University. Any rule framed/amended after my admission shall also be
binding upon me.If at any time, it is found that I had obtained admission by misrepresentation of facts or thatthe admission
was made erroneously I understand that the admission can be cancelled and fees and all other dues paid up to the date of
such removal shall be forfeited besides other action as may betaken against me according to law. I will abide by the rule of
75% attendance for being eligible to appear in the examination.If my attendance in aggregate is below 33% my name may
be struck off and Ishall not request for re-admission. I will abide by rules regarding Curbing the Menace of Ragging, 2009.

Note: Your application has been successfully submitted to CCSHAU, Hisar. You are not required to send any Documents or
Application PDF to the University,