JEE (Main) April ConfirmationPage
JEE (Main) April ConfirmationPage
JEE (Main) April ConfirmationPage
Personal Details
Name: ADITI ANIL ANGADI Date of Birth: 29/08/2001
Mother's Name: SUJATA A ANGADI Category: GENERAL
Caste Name: NA Father's Name: ANIL S ANGADI
Person with Disability(PwD): NO State of Eligibility: KARNATAKA
Percentage of Disability: -- Gender: FEMALE
Are you Diabetic: NO Nationality: INDIAN
Place of Residence: URBAN Do you need scribe: NO
Examination Details
Applying For: JEE(Main) Paper - 1 (B.E./B.Tech.) Only
Mode of Examination: COMPUTER BASED EXAMINATION Question Paper Medium: ENGLISH
1st Choice of Exam City: DHARWAD (KARNATAKA) 2nd Choice of Exam City: HUBLI (KARNATAKA)
3rd Choice of Exam City: BELAGAVI(BELGAUM) (KARNATAKA) 4th Choice of Exam City: BENGALURU (KARNATAKA)
Academic Details
Year of passing class 10th: 2017 Place of 12th class schooling: CITY
Year of Passing or Appearing class 12th/Qualifying Exam: 2019 Type of Institution of Class 12th/Qualifying Exam: PRIVATE
School Board of class 12th/Qualifying Exam: KARNATAKA BOARD OF PRE UNIVERSITY EDUCATION
Name of the Qualifying Exam passed / appearing: Intermediate or two-year Pre-University examination conducted by a recognized Board/ University.
Percentage of Marks in Class 12th/Qualifying Exam: -- Roll No. of Class 12th/Qualifying Exam: --
Appeared/Appearing for Improvement of Class NO Mode of preperation: COACHING
12th/Qualifying Exam:
Roll Number of Class 12th/Qualifying Exam of --
Improvement Exam:
Name and Address of the School/College from where SHRI MANJUNATHESHWARA PRE UNIVERSITY SCIENCE COLLEGE VIDYAGIRI,DHARWAD,KARNATAKA-
passed/appearing: 580004
Guardian Details
Qualification Occupation Annual Income
Father's/Guardian's: GRADUATE BUSINESS UPTO 100000
Mother's: GRADUATE OTHERS UPTO 100000
Payment Details
Provider Name: Syndicate Bank Payment Mode: e-Challan
Fee Type: Examination Fee for JEE(Main) April 2019 Transaction Amount: 250 /-
Transaction ID: 101332 Date of Transaction: 2019-02-15
DECLARATION
I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief.