BATCH (2021-22)

IntERvIEw InFoRMAtIon ShEEt (FoRM -A) Form A

INTERVIEW INFORMATION SHEET
CSRL Abhyudaya, APS Beas
Name: Prabal army
Joint suPer 50
Association
(Indian Army Western Command, CSRL & APS, Beas) (a unit of CSRL )
pune, sukna & beas Student’s
ARMY
Two Years of IIT-JEE SUPER
& NEET Free 50
Coaching - “PRABAL”
Programme for Class XIth &Photograph
XIIth : 2024-26
Free Residential Coaching for JEE Main & Advanced (2023-24)
BATCH (2021-22)
IntERvIEw InFoRMAtIon ShEEt (FoRM -A) Form A
INTERVIEW INFORMATION SHEET
State : Pincode:
Whatsapp No.:................................................ Student’s Signature

(B) ACADEMIC DETAILS : CLASS X, XI & XII

Name:
ůĂƐƐ EĂŵĞŽĨ^ĐŚŽŽů ŽĂƌĚ  ĚĚƌĞƐƐǁŝƚŚWŝŶĐŽĚĞ WĂƐƐŝŶŐzĞĂƌ 
Student’s
Photograph
 
y

State : Pincode:
y/
 Whatsapp No.:................................................ Student’s Signature

(B) ACADEMIC DETAILS : CLASS X

y//
ůĂƐƐ
 EĂŵĞŽĨ^ĐŚŽŽů ŽĂƌĚ  ĚĚƌĞƐƐǁŝƚŚWŝŶĐŽĚĞ WĂƐƐŝŶŐzĞĂƌ 

 
y
(C) JEE Main & Advanced 2023 DEtAILS : (If appeared, provide details)
DŽŶƚŚ WĞƌĐĞŶƟůĞKďƚĂŝŶĞĚ ĞƐƚŽĨdŚƌĞĞ
Best of Two
(C) ƉƉůŝĐĂƟŽŶEŽ͘
y/


STREAM (Choose the right option) ϮϬϮϭ Phy Chem  Maths dŽƚĂůWĞƌĐĞŶƟůĞ
Total Percentile 
Medical : Engineering :
y//


(D)JEE Main & Advanced 2023 DEtAILS : (If appeared, provide details)
(C)
WĞƌĐĞŶƟůĞKďƚĂŝŶĞĚ ĞƐƚŽĨdŚƌĞĞ
Best of Two
ƉƉůŝĐĂƟŽŶEŽ͘ DŽŶƚŚ Chem  dŽƚĂůWĞƌĐĞŶƟůĞ 
 ϮϬϮϭ Phy Maths Total Percentile

Rank: Rank:

Unit:
(D)
Unit:

(E) UNDERTAKING:
/ŚĂǀĞƵŶĚĞƌƐƚŽŽĚƚŚĞƉƌŽũĞĐƚĂŶĚŐŝǀĞŵLJǁŝůůĨƵůĐŽŶƐĞŶƚƚŽĂƉƉĞĂƌŝŶƚŚĞŽŶůŝŶĞŝŶƚĞƌǀŝĞǁŽĨƌŵLJ^ƵƉĞƌϱϬͲWƌŽũĞĐƚ͞WƌĂďĂů͘͟
“ CSRL Abhyudaya, APS Beas ”
/ĂůƐŽƵŶĚĞƌƚĂŬĞƚŚĂƚ/ǁŽƵůĚŶŽƚƌĞƐŽƌƚƚŽĂŶLJŬŝŶĚŽĨŵĂůƉƌĂĐƟĐĞƐ͕ĂŶĚƵŶůĂǁĨƵůĂĐƟǀŝƚLJĚƵƌŝŶŐƚŚĞŽŶůŝŶĞŝŶƚĞƌǀŝĞǁƉƌŽĐĞƐƐ͘
Rank: Rank:
/ŶĐĂƐĞ/ĂŵĨŽƵŶĚŽĨƌĞƐŽƌƟŶŐƚŽĂŶLJƐƵĐŚĂĐƟǀŝƚLJ͕ƚŚĞŵĂŶĂŐĞŵĞŶƚĐĂŶĐĂŶĐĞůŵLJĐĂŶĚŝĚĂƚƵƌĞ͘
Unit: Unit:

Candidate
(E) UNDERTAKING:
Parent/Guardian
Signature: Signature:
/ŚĂǀĞƵŶĚĞƌƐƚŽŽĚƚŚĞƉƌŽũĞĐƚĂŶĚŐŝǀĞŵLJǁŝůůĨƵůĐŽŶƐĞŶƚƚŽĂƉƉĞĂƌŝŶƚŚĞŽŶůŝŶĞŝŶƚĞƌǀŝĞǁŽĨƌŵLJ^ƵƉĞƌϱϬͲWƌŽũĞĐƚ͞WƌĂďĂů͘͟
/ĂůƐŽƵŶĚĞƌƚĂŬĞƚŚĂƚ/ǁŽƵůĚŶŽƚƌĞƐŽƌƚƚŽĂŶLJŬŝŶĚŽĨŵĂůƉƌĂĐƟĐĞƐ͕ĂŶĚƵŶůĂǁĨƵůĂĐƟǀŝƚLJĚƵƌŝŶŐƚŚĞŽŶůŝŶĞŝŶƚĞƌǀŝĞǁƉƌŽĐĞƐƐ͘

/ŶĐĂƐĞ/ĂŵĨŽƵŶĚŽĨƌĞƐŽƌƟŶŐƚŽĂŶLJƐƵĐŚĂĐƟǀŝƚLJ͕ƚŚĞŵĂŶĂŐĞŵĞŶƚĐĂŶĐĂŶĐĞůŵLJĐĂŶĚŝĚĂƚƵƌĞ͘

Candidate
CsRL Transforming Lives
Parent/Guardian
Signature: A-33, Swasthya Vihar, New Delhi-110092 | www.csrl.in
Signature:

Project Executed by :-
CSRL - Transforming Lives
CsRL Transforming Lives
A-33, Swasthya Vihar, New Delhi-110092 | www.csrl.in
A-33, Swasthya Vihar, New Delhi-110092 | www.csrl.in