3/27/2015 https://upseeuptu2015.in/Confirmations.aspx

https://upseeuptu2015.in/Confirmations.aspx 1/2

CONFIRMATIONPAGE:UPSEE2015(APPLICATIONFORMFORADMISSIONTOFIRSTYEARINB.TECH/B.PHARM./B.ARCH/BHMCT/BFAD/BFA/MAM/MBA/M.C.A.LATERALENTRY(SECONDYEAR)INB.TECH.ANDB.PHARMA)

RegistrationNo./ApplicationID30285982

YouhavesuccessfullysubmittedApplicationOnline.Kindlytaketheprintoutofthispage.Pasteyouronepassportsizephotographandputyoursignatureandthumbimpressioninthespecifiedbox.ModeofapplicationFormFilling Online DateofBirth 11/02/1993

Candidate'sName SANDEEPRAO Category UPSC

Father'sName RAMCHANDRARAO SubCategory NOTAPPLICABLE

Nationality INDIAN RuralWeightage NA

Parent'sDomicile U.P. YearofPassing 2014

Gender Male QualifyingExam GRADUATION

SeekingAdmissionFor MBA QualifyingExamPassedFrom U.P.

Subjectin10+2

Paper(s)toAppear Paper9

ChoiceofExamCentres Lucknow|Bahraich|FaizabadDECLARATION

IcertifythattheparticularsgivenbymeinthisApplicationFormarecorrecttothebestofmyknowledgeandbeliefandanymastake/misinformationdetectedatthetimeofcounsellingoratanystagewillresultinthecancellationofadmissionIhavecarefullyreadtheInformationBrochureofUPSEE2015andagreetoabidebythetermsandconditionslaiddowntherein.Further,itisentirelymyresponsibilitytoprovetheeligibilityforadmissiontothe1styearofB.Tech./B.Arch./B.Tech.(AgricultureEngg.)/B.Tecch.(BioTech)/B.Pharma./B.HMCT/BFAD/BFA/2ndyearofB.Tech./B.Pharmacourse(s)inrespectofqualificationandentitlementforadmissionagainstreservedcategory,ifclaimed,tothesatisfactionoftheUPSEE2015.Further,IundertakethatIwillbevisitingthewebsite(http://upseeuptu2015.in)regularlyforanyinformationandIdeclarethatalltheinformationregardingUPSEE2015providedonthesewebsitewillbetreatedasserved.

Name: SANDEEPRAO

Address: Sufipura,nearforestoffice,BahraichState: U.P.

PinCode: 271801EmailID: Sandeeprao9044@gmail.comMobileNo. 9044325116

UploadedSignature

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Placeyourrecentcolouredphotographasprintedonconfirmationform(3.5cmx4.5cm)

LeftHandThumbImpression SignatureoftheCandidate(Notincapitalletters) SignatureofParent/Guardian

SendthisformalongwithcopyofBankChallan(iffeepaidbyBankChallan)to"REGISTRAR,UPSEE2015,UTTARPRADESHTECHNICALUNIVERSITY,I.E.T.CAMPUS,SITAPURROAD,LUCKNOW226021,(U.P.)"soastoreachlatestby5PM,09042015.

3/27/2015 https://upseeuptu2015.in/Confirmations.aspx

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DetailsofFeeTransaction.For

ApplicationID30285982TransactionID. ModeofPayment Amount: TransactionDateDU14151595 SBIiCollect 400.00 25/03/2015

Note:Pleaseensurethatalltheentriesarefilledupandtransactiondetailsofbankareavailableontheconfirmationpage,failingwhichyourapplicationisliabletoberejected.