Jyoti Nivas College Autonomous

Hosur Road, Bangalore 560 095

SCIENCE APPLICATION 2240119

BSCPY - BSc
Preference 1: UTR No.:
PSYCHOLOGY(SM)(BSPY)
Application Fee
Transaction Date:
Branch Code:

Name: SIMRAN e-mail: simranyadav1334@gmail.com

Gender: Female Blood Group: B+VE
Date of Birth: 25/08/2006 Place of Birth: Narnaul
Belongs to : Rural
Nationality: INDIAN
Religion: HINDU
Category: OBC
Aadhar No: 861128798349 PAN No:
Phone Number: +91 8607818890
Mobile: +91 8607818890
Are you differently abled?: No
Second Language Studied: Additional English

Mother Tongue: Hindi

Passport Details
Passport Issuing
Passport No.: 0
Country:
Passport Valid up to: Resident Permit No.:
Date of Resident Permit Obtained from
Commissioner of Police, Bangalore:
Visa No: Validity Date:

Educational Qualification:
Qualification: Board/Uni Institution State: Y/M of Pass Attmp
 Motilal Nehru 1
PUC Cbse Haryana 2024, April
Schoo
Motilal Nehru 1
SSLC Cbse Haryana 2022, May
Schoo
Subject Wise marks details
Sl. No. Subject Name Max. Marks Obtained Marks
1 English 100 79
2 Physics 100 58
3 Chemistry 100 67
4 Mathematics 100 51
5 information practice 100 75
TOTAL: 500.0 330.0
OverAll % 66.0
1 English LNG & LIT 100 92
2 Hindi course - A 100 97
3 Mathematics Standard 100 73
4 Science 100 95
5 Social science 100 85
TOTAL: 500.0 442.0
OverAll % 88.4

Parent Details:
Father's Name Sanjay Mother's Name Mukesh
Qualification: Graduate Qualification: Post Graduate and Above
Occupation: Farmer Occupation: Housewife
Annual Income: RsBelow 1,00,000 Annual Income: RsBelow 1,00,000
Father's Phno: 9306518890 Mother's Phno: 9306518890
e-mail: e-mail:
Jaikumar33590@gmail.com Simrandabar2508@gmail.com
PAN No: PAN No:
Current VPO NAHAR TEH KOSLI DISTT REWARI , VPO NAHAR TEH KOSLI DISTT
Address REAWRI, Rewari, Haryana, India, 123303
Permanent VPO NAHAR TEH KOSLI DISTT REWARI , VPO NAHAR TEH KOSLI DISTT
Address REAWRI, Rewari, Haryana, India, 123303
Games & Athletics

Participated Sports/Athletics Level Prize Won

Participated in Debate/Essay writing/Drawing/Quiz etc.

Participated Co-Curricular Level Prize Won

 DECLARATION
I hereby affirm that I will abide by the rules of conduct and discipline of the college. I
will abstain from practicing ragging in any form.I shall attend either religious or Value
Education classes. I also declare that the statements I have made in the application are
correct.I will adhere to the dress code prescribed by the college.I will avoid usage of
cell phone on the campus&in the class room.I shall be regular in attending the college
and secure a minimum of 85% of attendance per subject.
Place
Date Signature of the Candidate

DECLARATION
I shall be responsible for the payment of my daughter's/ward's fees.I stand responsible
for her conduct and good behaviour during the period of her college career.I
understand that students may be asked to leave the college at any time for
misbehaviour and irregular attendance,in each subject.

Place
Date Signature of the Parent/Guardian