2/27/2019

Application for UET-2019

[Opted Test Mode :COMPUTER BASED TEST (CBT)]

REGISTRATION NO: BHU00652163132 PAYMENT ID: BHUU56521630844N

IDENTIFICATION TYPE : Aadhaar Card IDENTIFICATION NO. Not Applicable for Aadhaar Card

Course Code & Name: (132) B. A. (Hons.) Social Sciences

पाठय म का नाम :
Candidate Name: RAVI KUMAR
आवेदक का नाम :
Father's Name: SANJAY SAW
िपता का नाम :
Mother's Name: PRABHA DEVI
माता का नाम:
Father's / Mother's Mobile 9771526391
Number:
िपता / माता का मोबाइल नंबर :
Date of Birth: 25. September .2001
ज ितिथ :

Sex/िलंग: MALE Category/वग: OBC

Blood Group: NOT KNOWN Do you claim Reservation for
ड ुप : Economically Weaker Section (EWS) ?
Physically Challenged: NO Employee's Ward: NO
शारी रक िवकलां गता: कमचारी पु पु ी :

Nationality/रा ीयता : Indian Sports Seat: NO

ोट् स सीट :
Religion/धम: HINDU

Address For Correspondence प ाचार का पता Permanent Address थायी पता

Name: RAVI KUMAR Guardian's Name (If
आवेदक का नाम Applicable)
VILL+POST - KUJAPI. PS - CHANDAUTI. DIST - GAYA. STATE Address (पता ) : VILL+POST - KUJAPI. PS - CHANDAUTI. DIST - GAYA. STATE
Address (पता ) :
- BIHAR PIN CODE :- 823002 - BIHAR PIN CODE :- 823002

District (िजला): GAYA District (िजला): GAYA

State (रा ): Bihar State (रा ): Bihar

823002 Pin (िपन) : 823002

Pin (िपन) :
Ph. No. with STD Code Ph. No. with STD Code

Mobile No. (मोबाइल नंबर ) 8804443767 Fax No.

Mobile No. (मोबाइल नंबर) 8804443767
Email kravi2509001@gmail.com

Distance of your Residence from 500-999 Annual Income of your Less than 2,00,000
BHU . Parents/Guardians in Rs.

Test Center Preference परी ा के व रयता Opted Test Mode : COMPUTER BASED TEST (CBT)
Preference - 01 Varanasi [ Uttar Pradesh ] Preference - 04 Allahabad [ Uttar Pradesh ]
Preference - 02 Ranchi [ Jharkhand ] Preference - 05 Bokaro Steel City [ Jharkhand ]
Preference - 03 Patna [ Bihar ]

Signature Uploaded by
the candidate
अ थ ारा अपलोडे ड
ह ा र

It is hereby confirmed that I have carefully read the concerned Information Bulletin available on the BHU's Entrance Test Portal (www.bhuonline.in) before filling up the Application Form.
I hereby solemnly affirm that the information furnished in this Online Application Form is true and correct to the best of my lnowledge and belief and no material information has been concealed or
suppressed. If any information is found to be false, incorrect or misleading, the Banaras Hindu University shall have the authority to cancel my candidature / admission without any further enquiry
or notice.
I undertake that, if admitted, I shall abide by the UGC Regulations on Curbing the Menace of Ragging, 2009, Ordinances governing the discipline of students of banaras Hindu University and
such other Rules, Ordinances and Regulations that may be framed by the Banaras Hindu University/ UGC from time to time.
I further undertake that the preference for the Test center, Courses, Domicile and the categories to which I belong as indicated by me in the online application form shall be irrevocable.

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