9/16/23, 4:24 PM Registration Form

Maa Shakumbhari University, Saharanpur, Uttar Pradesh

माँ शाकु म्भरी विश्वविद्यालय, सहारनपुर, उत्तर प्रदेश
GRADUATION : REGULAR REGISTRATION FORM
SESSION 2023-2024
PERSONAL DETAILS [ व्यक्तिगत विवरण ] Print Time : 9/16/2023 4:23:23 PM

Registration Number: 23000116 Applied Course: Course ID:

Candidate Name: ANJUL KUMAR Father Name: SHIV KUMAR
Date of Birth 04/05/1995 Mother Name: SAVITRI DEVI
Physical Handicap: NONE Gender: MALE
Mobile Number: 7417072453 E-Mail Address: 95KANJUL@GMAIL.COM
Domicile State Uttarakhand Domicile Certificate No.: NONE
Caste/Category: GENERAL(UR) Caste/Category Certificate No.: NONE
Reservation Category: NONE Reservation Category Certificate No.: NONE
Other Category: NONE Income Group: BELOW 2 LAC PER ANNUM
Religion: HINDU
Is Minority: NO Minority Certificate No: NONE
Marital Status MARRIED Nationality INDIAN
Sports Quota Opted: NO EWS Status: NO
Aadhar Number: ********9984 Aadhar Enrollment Address:
Medium of Instructions /
Medium of Examination: ENGLISH ENGLISH
Communications:
Academic Bank Of Credit ID.: NONE Migration Certificate No.: 103
University Claim: NONE N.C.C. Claim: NONE
N.S.S. Claim: NONE Scouting Claim: NONE
Admitted College: 707-AAKANSHA COLLEGE, MEERAPUR, MUZAFFARNAGAR
Admitted Course: 064-B.SC. (HOME SCIENCE)
Selected Subjects: 282-HOME SCIENCE
ADDRESS DETAILS
CORRESPONDENCE ADDRESS DETAILS
Address VILL JHABRERI KALAN , POST JHABRERA , DISTT HARIDWAR , UTTARAKHAND State UTTARAKHAND
District HARIDWAR Pin Code 247665
PERMANENT ADDRESS DETAILS
Address VILL JHABRERI KALAN , POST JHABRERA , DISTT HARIDWAR , UTTARAKHAND State UTTARAKHAND
District HARIDWAR Pin Code 247665
QUALIFICATION DETAILS
PASSING MARKSHEET MAX MARKS PER(%)/GRADE
EXAMINATION BOARD / UNIVERSITY ROLL SUBJECT
YEAR NO MARKS OBTAINED /POINTS
HINDI MATH
HIGH SCHOOL OR BOARD OF SCHOOL EDUCATION,
2010 0009030 006389 0500 0282 56.40 SCIENCE
EQUIVALENT UTTRAKHAND.
ENGLISH SST
HINDI ENG PHY
INTERMEDIATE OR U.P. BOARD OF HIGH SCHOOL &
2013 4036254 0521210 0500 0334 66.80 CHEMISTRY
EQUIVALENT INTERMEDIATE EDUCATION, PRAYAGRAJ.
BIOLOGY
10th Subject(Home Science,Maths): MATHS
COURSE APPLIED & PAYMENTS DETAILS
Intermediate Stream 1-12th Biology Group
Note for College:- Please Enter Course ID to add student for merit in college.
Declaration

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9/16/23, 4:24 PM Registration Form

I declare that I have never been convicted for any criminal act and that there is no case pending against me in the court of law. I also declare that I
have never been caught using Unfair Means or any Disciplinary action has been taken against me. If I was charged for using Unfair Means, the
punitive duration is over and charges have been cleared.
I have read carefully and have understood all rules as mentioned in the University Rules and Admission Brochure.
Furthermore I also declare that if my application is found to contain incorrect/false information regarding my Name, Birth Date, Gender, Religion,
Domicile, Weightage, Caste, Horizontal Reservation, Marks obtained or any other field, my application is liable to get cancelled, and I will have no
objection in getting disqualified for admission to the concerned course/college.
_________________________________ _________________________________
Signature of the Parent/Gaurdian Signature of Candidate
Date: ___________________ Date: ___________________

NOTE: Mark the number of documents(Photocopy) attached by the Candidate during form submission to the college, and also carry all
documents in Original.

Application Form (Printout) Fee Receipt (Printout)

Xth Marsheet Xth Certificate

XII th Marsheet Under Graduate Marksheet

Recent Passport Sized Photograph Scanned Signature

Domicile (for other state) Certificate for Kashmiri Resident

Certificate for Horz./Reservation Certificate Certificate for Vert./Caste Category

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