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GOVIND BALLABH PANT UNIVERSITY OF AGRICULTURE & TECHNOLOGY

PANTNAGAR -263145 (UTTARAKHAND)

APPLICATION FORM FOR UG PROGRAMMES

ENTRANCE EXAMINATION:2024

Registration Number: 109656

Candidate Name: RAKHI Examination Appearing For: UG
Father's Name: VIKRAM SINGH Mother's Name: MEERA DEVI
Nationality: Indian Date of Birth: 03/04/2004
Age As on 31.12.2024 : 20 Year(s), 8 Month(s), 28 Day(s) Gender: Female
Place Option 1: Dehradun Place Option 2: Rishikesh
Son/Daughter/Spouse of Regular Employee
Bonafide Resident of Uttarakhand: YES NO
of This University:
Blood Group: O RH Factor: RH+
Group of Paper/Subject Paper (Only For
PCB (01) Qualifying Examination?: Passed
UG):
Have You Ever been student of
NO Student ID (In case of Yes)
GBPUA&T? :
Category Code: 1200 Religion: Hindu
Category: Other backward classes of uttarakhand Sub Category: Uttarakhand Backward Classes
Email: rakhipanwar32085@gmail.com Mobile Number: 8279740164
Landline Number: Aadhar Number: 955128852912
Application Fee Payment Details:
Reference Number: 010962804240741857 Paid Amount: 1200
Payment Mode: UPI Transaction Date: 28-04-2024 19:53:39
Correspondence Address Details:
VILL - KHASONSI P.O. - SHRIKOT,
Address: State: UTTARAKHAND
JAUNPUR
District: TEHRI GARHWAL Pin Code: 249186
Parmanent Address Details:
VILL - KHASONSI P.O. - SHRIKOT,
Address: State: UTTARAKHAND
JAUNPUR
District: TEHRI GARHWAL Pin Code: 249186
Qualification Details:
Passing
Examination Board/University Division Marks/OGPA Percentage(%) Institute Name Subjects/Degree
Year
High School or FIRST G. I. C. SHRIKOT JAUNPUR HINDI, ENGLISH, MATHS, SCIENCE,
UK BOARD 2020 404 80.4%
Equivalent DIVISION TEHRI GARHWAL SOCIAL SCIENCE.
Intermediate or FIRST G. I. C. SHRIKOT JAUNPUR PHYSICS, CHEMISTRY, BIOLOGY,
Equivalent UK BOARD 2022 DIVISION 301 60.2% TEHRI GARHWAL ENGLISH, HINDI.
Graduation
Post Graduation
Others

I hereby declare that the particulars filled are true, correct and complete to the best of my knowledge and belief and nothing has been
concealed, In case any of the information is found to be false, incorrect or misleading at any stage I shall have no claim against
cancellation of my candidature and/or taking other legal action as deemed fit by G.B. Pant University of Agriculture & Technology.

Left Thumb Impression of Candidate Signature of Candidate

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