1:41:55PM8/12/2015Print Date & Time :

Registration Date : 12/08/2015Registration No. : 15P7387684

ankitcomputer@gmail.com

1. Name of the Candidate (IN BLOCK LETTERS) :

YASHIKA

2. Father's Name (IN BLOCK LETTERS) :

MR. SUNIL SIROHI

3. Mother's Name (IN BLOCK LETTERS) :

MRS. RENU SIROHI

4. Date of Birth : 31/08/1994

15. Nationality : INDIAN

6. Gender : FEMALE

OBC

UTTAR PRADESH

HINDU12. Religion :

8. Category :

7. Res. Category :

5. Domicile :

13. Email ID :

GIRLS

Applying For : PGConfidential No. : 632352

10. SC/ST/OBC Certificate No. : 11. Other Category :

14. Do You Belong To Minority Category? :

9. Income Group :

073143018554

NO

Below 5 Lacs

17. Address

7895630700Mobile :Phone :

250110Pin :

MEERUTDistrict :

MEERUTAddress :

Address of Correspondence

250110Pin :

MEERUTDistrict :

MEERUTAddress :

Permanent Address

Signature of Candidate

Photo of Candidate

16. Have You Taken No Objection Certificate From (SP) (Optional) : NO

Unique Identification Details

18. 10th Marksheet Sr. No. : 19. 10th Roll No. :

20. 10th Passing Year :

5279397

2009

0560126

21. 12th Roll No. :

22. Enrollment No. ( In Case of CCSU Student) : M11205988

5691540

SESSION : 2015 - 2016

CHAUDHARY CHARAN SINGH UNIVERSITY, MEERUTCandidate Registration Form

Name of the Candidate (IN HINDI) :

Father's Name (IN HINDI) :

Mother's Name (IN HINDI) :

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24. Whether you were punished for any offense / unfair means committed by you in the previously attended or the present institution (If yes, give details ) :

23. Remarks (In Case of NRI ) :

25. Weightages Claimed :

Weightage DescriptionSNo. WeightageStudent of University1 4 %

Board/UniversitySubjects TakenExam StreamMarks Obt.Max MarksYearExamination PassedSNo.Central Board of Secondary Edu. 2, Community Centre, Shiksha Kendra, Preet Vihar, Delhi-110 092.

ALL 415 500 2009Matriculation1

Central Board of Secondary Edu. 2, Community Centre, Shiksha Kendra, Preet Vihar, Delhi-110 092.

PCB ENGLISH BIOTECHNOLOGY

PCB + English 343 500 2011Intermediate2

CCS UNIVERSITYB.Sc (Biotechnology) 930 1500 2014Graduation3

26. Academic Record :

27. Apply Details :

List of Colleges ( Name of College, Degree and Subjects Combination should entered by the candidate for which he /she wants to apply )

SubjectsDegreeCollege NameSNo.

1 PI || BHAGWATI COLLEGE OF MGMT AND TECHNOLOGY SIVAYA, ROORKEE ROAD, MEERUT

M.SC (BIOTECHNOLOGY)

BIOTECHNOLOGY

2 GA || DEPARTMENT OF BIOTECHNOLOGY (CAMPUS) M.SC (BIOTECHNOLOGY)

BIOTECHNOLOGY

3 PI || MEERUT INST. OF ENGINEERING AND TECHNOLOGY BAGHPAT CROSSING, PARTAPUR BY PASS, MEERUT

M.SC (BIOTECHNOLOGY)

BIOTECHNOLOGY

NOTE: Mark the number of documents ( Photocopy/Xerox) attached by the Candidate during form submission to the college :(a) Xth Marksheet (b) Xth Certificate. (c) XIIth Marksheet.

(f) Signature(e) Photograph(d) Last Exam Passed Marksheet(i) Certificate for Horz./Reservation Category(h) Certificate for Kashmiri Migrants.(g) Domicile (for other state)

(j) Certificate for Vert./Caste Category

1. / / |2. / |3. / , / / |4. / / |5. / / 100% / 75% / |6. , / / |7. |

Undertaking

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Signature of the Applicant him / herself

Signature of Parents/Guardian

Dated :

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