Government of Karnataka

Karnataka Examinations Authority

Common UG Online Application - 2024
2024

2024-25 2

BPO
Common Online Common Application for Engineering, Naturopathy & Yoga, Veterinary, B. Pharma, 2nd year B.Pharma and Pharma-D, Farm
Science courses [B.Sc. (Hons) Agriculture, B.Sc. (Hons) Sericulture etc.,], and B.Sc. (Nursing) courses [including Architecture, Medical, Dental,
Ayurveda, Unani, Homoeopathy, B.P.T., B.Sc. Allied Health Sciences, BPO courses] for the Year 2024-25

Its only a Edit Copy to check the details - Take the FINAL Copy after Payment. Appln No:
3920220808729

Online Application Form

I.General Details

Candidate Name : YUKTHA E

ತಂದ Father Name/Guardian Name BHASKAR REDDY E

Mother Name HEMA E

ಂ Date of Birth 05-08-2006

ಂ Mobile Number & Email 98XXXXXX37 - b****7@g****l.com

Candidate Nationality INDIAN - Resident of India

ಂ Candidate Gender FEMALE

Candidate Address 5TH GROUND FLOOR 3RD MAIN NATARAJLAYOUT,

PUTTENAHALLI, JP NAGAR 7TH PHASE, BENGALURU
SOUTH, BENGALURU URBAN, KARNATAKA - 560078
Caste Reservation Claimed / Income Details

Religion HINDU

Reservation category - 3A - REDDY

Name of the Caste

ತ ಂ RD0039268488646
Caste Certificate RD Number
ದ ತ ಂ Income Certificate RD
Number
Annual Income 50000

Other Reservation claimed Details

RELIGIOUS MINORITY NO
LINQUISTIC MINORITY YES CLAIMED
STUDY IN KANNADA MEDIUM FROM 1 TO 10TH NO
STUDY IN RURAL AREAS FROM 1 TO 10TH NO
JAMMU & KASHMIR MIGRANTS NO
KALYANA KARNATAKA (371 (J)) NO
Printed Date: 25-01-2024 04-01-32 Page No: 1
 Government of Karnataka
Karnataka Examinations Authority
Common UG Online Application - 2024
2024

2024-25 2

BPO
Common Online Common Application for Engineering, Naturopathy & Yoga, Veterinary, B. Pharma, 2nd year B.Pharma and Pharma-D, Farm
Science courses [B.Sc. (Hons) Agriculture, B.Sc. (Hons) Sericulture etc.,], and B.Sc. (Nursing) courses [including Architecture, Medical, Dental,
Ayurveda, Unani, Homoeopathy, B.P.T., B.Sc. Allied Health Sciences, BPO courses] for the Year 2024-25

Its only a Edit Copy to check the details - Take the FINAL Copy after Payment. Appln No:
3920220808729
NRI-WARD NO

Academic Details
Quota claimed / ತ Eligibility Clause Code KARNATAKA - CLAUSE - A

ತೃ ಭ ಷ Mother Tongue TELUGU

Do you write/appearing Board Exam of 12th in Karanataka? Yes
ಂ ಂ ತ 9
Total number of years of study in Karnataka (From 1st to 12th Std.)
ಂ KARNATAKA ( STATE BOARD )
State of 2nd PUC / 12th/ Equivalent exam & Qualifying Examination Board
College Type PRIVATE
ಂ KARNATAKA ( STATE BOARD )
State of 2nd PUC / 12th/ Equivalent exam & Qualifying Examination Board
District of 2nd PUC/12th/Equivalent exam (if studied in karnatka) BENGALURU URBAN
ದ ಂ PUC Student Number & Year of 2023AS07550096 - 2024-
Passing
ಂ YES - 20220808729

Completed SSLC from KSEEB, Govt. of Karnataka? and Registration

Number
ಂತ ಂ NO

Have you Appeared for NEET Exams before 2023? / CET Number / Year of
appearance

Applied Courses
UG - CET Enggineering/Nursing/Veternary/Yoga & Naturopathy/Agriculture/Pharmacy

Exam Ceners
Exam Center (Priority 1) BENGALURU SOUTH
Exam Center (Priority 2) BENGALURU NORTH

Printed Date: 25-01-2024 04-01-32 Page No: 2

 Government of Karnataka
Karnataka Examinations Authority
Common UG Online Application - 2024
2024

2024-25 2

BPO
Common Online Common Application for Engineering, Naturopathy & Yoga, Veterinary, B. Pharma, 2nd year B.Pharma and Pharma-D, Farm
Science courses [B.Sc. (Hons) Agriculture, B.Sc. (Hons) Sericulture etc.,], and B.Sc. (Nursing) courses [including Architecture, Medical, Dental,
Ayurveda, Unani, Homoeopathy, B.P.T., B.Sc. Allied Health Sciences, BPO courses] for the Year 2024-25

Its only a Edit Copy to check the details - Take the FINAL Copy after Payment. Appln No:
3920220808729
Study Details
ಂ

Name and Address of the District ತ Passed Passed Board Area Medium
School and Address Class Year
CAMLIN SCHOOLNO 15, BENGALURU 4 2016 State URBA Kannada
ACHAPPA LAYOUT, J P SOUTH N
NAGAR 7th PHASE,
BANGALORE
CAMLIN SCHOOLNO 15, BENGALURU 5 2017 State URBA Kannada
ACHAPPA LAYOUT, J P SOUTH N
NAGAR 7th PHASE,
BANGALORE
CAMLIN SCHOOLNO 15, BENGALURU 6 2018 State URBA English
ACHAPPA LAYOUT, J P SOUTH N
NAGAR 7th PHASE,
BANGALORE
CAMLIN SCHOOLNO 15, BENGALURU 7 2019 State URBA English
ACHAPPA LAYOUT, J P SOUTH N
NAGAR 7th PHASE,
BANGALORE
CAMLIN SCHOOLNO 15, BENGALURU 8 2020 State URBA English
ACHAPPA LAYOUT, J P SOUTH N
NAGAR 7th PHASE,
BANGALORE
CAMLIN SCHOOLNO 15, BENGALURU 9 2021 State URBA English
ACHAPPA LAYOUT, J P SOUTH N
NAGAR 7th PHASE,
BANGALORE
CAMLIN SCHOOLNO 15, BENGALURU 10 2022 State URBA English
ACHAPPA LAYOUT, J P SOUTH N
NAGAR 7th PHASE,
BANGALORE
SRI CHAITANYA PU BENGALURU 11 2023 STATE URBA -
COLLEGE#36 24MN RD SOUTH N
REDDY COMP JPNAGAR
PUTTENAHALLI
SRI CHAITANYA PU BENGALURU 12 2024 STATE URBA -
COLLEGE#36 24MN RD SOUTH N
REDDY COMP JPNAGAR
PUTTENAHALLI

Printed Date: 25-01-2024 04-01-32 Page No: 3

 Government of Karnataka
Karnataka Examinations Authority
Common UG Online Application - 2024
2024

2024-25 2

BPO
Common Online Common Application for Engineering, Naturopathy & Yoga, Veterinary, B. Pharma, 2nd year B.Pharma and Pharma-D, Farm
Science courses [B.Sc. (Hons) Agriculture, B.Sc. (Hons) Sericulture etc.,], and B.Sc. (Nursing) courses [including Architecture, Medical, Dental,
Ayurveda, Unani, Homoeopathy, B.P.T., B.Sc. Allied Health Sciences, BPO courses] for the Year 2024-25

Its only a Edit Copy to check the details - Take the FINAL Copy after Payment. Appln No:
3920220808729
Bank Details
Account Holder e bhaskar reddy Bank Name union bank
Name
IFSC Code ubin0816591 Bank Branch rbi layout
Account Number 16XXXXXXXXX0913

Payment Details

Uploaded Documents List

SSLC/10th standard Marks Card or equivalent Certificate
Caste/Income Certificate (For SC/ST in Form-D, Cat-1 in Form-E and 2A, 2B, 3A & 3B in Form-
F Issued by the concerned Tahsildar of Karnataka)
Lingustic Minority Certificate ( Issued by the Head of the Educational institution & contersigned by
BEO/DDPU (ANNEXURE-5 /ANNEXURE-5A ))
Passport Size Photo
Thumb Photo
Signature

1 ಂ ಂತ ಂ ಂ ದ ಂ ಂ

2 ಂ ತ ದ ತ ತ
ದ ಂದ ಂ ಂತ ದ
NOTE : 1. After completion of all the process the candidates are required to take final print out of the Online Application
Form and submit the same during Document Verification.
2. The CASTE and INCOME certificate to be produced by candidates during seat selection process should have the
same CASTE and INCOME, as mentioned in this Application Form. No change in Caste / Category will be
permitted after the final declaration.

Declaration

ಂತ ತ ಂ
ತಂ ಂ ಂ ಂ
ತಂ ಂ ಂ ಂತ ದ
ತ ತ ಂ ಂ ಂ ಂ ಂ ದ

We declare that the information furnished through online is true and correct to the best of our knowledge and
belief. We have read the instructions carefully hosted on the KEA website "Information Bulletin for Filling up of
Online Application". In case any of the information furnished online by us is found to be false or incorrect, We are
also liable for action, that the State Government or the KEA may take against us in this regard.

Printed Date: 25-01-2024 04-01-32 Page No: 4

 Government of Karnataka
Karnataka Examinations Authority
Common UG Online Application - 2024
2024

2024-25 2

BPO
Common Online Common Application for Engineering, Naturopathy & Yoga, Veterinary, B. Pharma, 2nd year B.Pharma and Pharma-D, Farm
Science courses [B.Sc. (Hons) Agriculture, B.Sc. (Hons) Sericulture etc.,], and B.Sc. (Nursing) courses [including Architecture, Medical, Dental,
Ayurveda, Unani, Homoeopathy, B.P.T., B.Sc. Allied Health Sciences, BPO courses] for the Year 2024-25

Its only a Edit Copy to check the details - Take the FINAL Copy after Payment. Appln No:
3920220808729

Left hand Thumb of

Signature of the
Candidate
Candidate

Printed Date: 25-01-2024 04-01-32 Page No: 5