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THE CANDIDATE IS REQUESTED TO RETAIN THE PRINTOUT OF THE CONFIRMATION PAGE FOR FUTURE REFERENCE. यितगत योरा (Contact Details) वतमान पता (Present Address) पता (Premises No/ Name) 14 ईमेल पता (Email Address) CHAILJOYJIT@GMAIL.COM थानीयता (Locality) UTTARPARA उप-थानीयता (Sub-Locality)(Optional) JK STREET दे श कोड (Country Code) 91 दे श (Country) INDIA राय (State) WEST BENGAL िजला (District) Hooghly वै किपक संपक सू (Alternate Contact मोबाइल नंबर (Mobile Number) 91 - 9836561483 9836366090 No.) (Optional) िपन कोड (Pin Code) 712258 थायी पता (Permanent Address) पता (Premises No/ Name) 14 थानीयता (Locality) UTTARPARA उप-थानीयता (Sub- JK STREET दे श (Country) INDIA Locality)(Optional): राय (State) WEST BENGAL िजला (District) Hooghly िपन कोड (Pin Code) 712258 यितगत योरा (PERSONAL DETAILS) अयथी की जम ितिथ (Candidate's Date अयथी का नाम (Candidate's Name) JOYJIT CHAIL 25-08-2005 of Birth) िपता / अिभभावक का नाम (Father / माता / अिभभावक का नाम (Mother / ABHIJIT CHAIL JHUMA CHAIL Guardian Name) Guardian Name) िलंग (Gender) MALE राटीयता (Nationality ) INDIAN पहचान के कार (Identity Type) PAN CARD पहचान संया (Identification Number) DBDPC0558L राय / केद शािसत दे श जहाँ से 12वीं / समक उीण / उपिथत (State/ UT WEST BENGAL े णी (Category ) OBC-(NCL) AS PER CENTRAL LIST from where 12th/ Equivalent Passed/ Appearing) या आपको मधुमेह ह (Are You NO िनवास की जगह ( Place of Residence ) URBAN Diabetic ? ) यिद आप एक Pwd उमीदवार ह , तो या आपके पास ब चमाक िवकलांगता है (If you वािषक पािरवािरक आय ( Annual Family NA 200001-300000 are a Pwd Candidate, do you have Income ) benchmark disability)? योयता परीा म कू ली िशा का मायम ( तैयारी का तरीका ( Mode of Preparation Self-Study Medium of schooling in qualifying English ) exam ) परीा कद िववरण (Exam centre Details) B. Planning, B.Arch., परीा के स के िलए आवे दन कर (Session के िलए आवे दन (Apply For) Session 1 & Session 2 B.E./B.Tech Of Exam Apply For) िपता / अिभभावक यवसाय (Father / िपता / अिभभावक योयता (Father / BUSINESS Matriculate Guardian Occupation) Guardian Qualification) माता / अिभभावक यवसाय (Mother / माता / अिभभावक योयता (Mother / Not Applicable GRADUATE Guardian Occupation) Guardian Qualification) परीा राय-पहला िवकप (Exam State परीा शहर-पहला िवकप (Exam City 1st WEST BENGAL HOOGHLY 1st Choice ) Choice ) परीा राय-दूसरा िवकप (Exam State परीा शहर-दूसरा िवकप (Exam City 2nd WEST BENGAL HOWRAH 2nd Choice ) Choice ) परीा राय-तीसरा िवकप (Exam State परीा शहर-तीसरा िवकप (Exam City 3rd WEST BENGAL KOLKATA 3rd Choice ) Choice ) परीा राय-चौथा िवकप (Exam State परीा शहर-चौथा िवकप (Exam City 4th WEST BENGAL KALYANI 4th Choice ) Choice ) न प मायम (Question Paper Medium) English th 10वीं या समक योयता िववरण (10 or equivalent Qualification Details) उीण / सिमिलत होने का वष (Year of उीण की िथित (Pass Status) Passed 2022 Passing/Appearing) योयता परीा (Qualifying Exam) 10 th or equivalent कू िलंग का थान (Place of Schooling) Urban कू ल / कॉलेज का कार (Type of School / योयता परीा राय (Qualifying Private Unaided WEST BENGAL College) Examination State) योयता परीा िजला (Qualifying COUNCIL FOR THE INDIAN SCHOOL Hooghly कू ल बोड (School Board) Examination District) CERTIFICATE EXAMINATIONS का 10वीं की माकशीट/माणप के vision international अनुसार िवालय/कॉलेज का नाम कू ल / कॉलेज का पता (School / College 56,T.N.MuKHERJEE Road , school,makhla, (School/College name should be as per Address) Makhla,Uttarpara, Hooghly uttarpara,hooghly Class 10th Mark sheet/certificate) कू ल / कॉलेज िपनकोड (School / College रोल नंबर 10वीं माणप के अनुसार (Roll 712245 7554661 Pincode) number as per 10th certificate) पिरणाम मोड (Result Mode) Percentage पूणा क (Total Marks) 1000.0 ातांक (Obtain Marks) 940.0 ितशत (Percentage) 94.00 th 12वीं या समक योयता िववरण (12 or equivalent Qualification Details) उीण / सिमिलत होने का वष (Year of उीण की िथित (Pass Status) Appearing 2024 Passing/Appearing) The final examination of the 10+2 system, conducted by any recognized Central/ State Board, such as the Central योयता परीा (Qualifying Exam) Board of Secondary कू िलंग का थान (Place of Schooling) Rural Education, New Delhi; Council for the Indian School Certificate Examinations, New Delhi etc. कू ल / कॉलेज का कार (Type of School / योयता परीा राय (Qualifying Private Unaided WEST BENGAL College) Examination State) योयता परीा िजला (Qualifying CENTRAL BOARD OF SECONDARY Hooghly कू ल बोड (School Board) Examination District) EDUCATION का 12वीं की माकशीट/माणप के Techno india group of अनुसार िवालय/कॉलेज का नाम कू ल / कॉलेज का पता (School / College public schools ,Konnagar konnagar ,nabagram (School/College name should be as per Address) nabagram Class 12th Mark sheet/certificate) कू ल / कॉलेज िपनकोड (School / College रोल नंबर 12वीं माणप के अनुसार (Roll 712246 NA Pincode) number as per 12th certificate) अितिरत जानकािरयां (Additional Details) या आप जु ड़वा ह और दोनों जे ईई (मे न) - 2024 के िलए आवे दन कर रहे ह NO (Are you a Twin and both applying for JEE (MAIN) – 2024)? आपातकालीन संपक िववरण प (Emergency Contact Details) दे श (Country) INDIA दे श कोड (Country Code) +91 मोबाइल नंबर (Mobile Number) 7003385157 ईमेल आईडी (Email ID) chailjhuma@gmail.com उमीदवार ारा अपलोड की गई छिवयां (IMAGES UPLOADED BY THE CANDIDATE)
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शु क भु गतान िववरण (Fee Payment Details)
भु गतान का कार (Payment Mode) Online लेन-दे न आईडी (Transaction ID) CPADGQSLN1 परीा शु क (Exam Fee) 1800.0 लेन-दे न की ितिथ (Date of Transaction) 20-11-2023 01:47:08 AM शु क जमा िकया गया (Fee Submitted 20-11-2023 01:45:29 AM On) घोषणा (Declaration) I declare that information furnished by me in the application form is true in all respect and nothing is concealed. In case any entry or information is found to be false, this shall entail automatic cancellation of my admission besides rendering me liable to such actions as deemed fit by the University. I hereby undertake that I have carefully gone through the eligibility conditions prescribed in the prospectus for the programme. I am applying after satisfying that I meet the eligibility conditions. If at any stage it is found that I do not fullfill the minimum prescribed criteria, my admission, if granted, shall stand cancelled and I shall have no right to admission whatsoever. IP Address : 122.172.174.215 Date of Downloading : 09-12-2023 12:13:19 PM