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Epass Application

This document is a registration form for fresh applicants to an education program for the 2015-2016 year. It requests information such as student details from SSC/CET exams, present college details, contact information, ID uploads, caste and income details, and academic history. Photograph upload is also required.

Uploaded by

Sunil RAYALASEEMA GRAPHICS
Copyright
© © All Rights Reserved
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208 views

Epass Application

This document is a registration form for fresh applicants to an education program for the 2015-2016 year. It requests information such as student details from SSC/CET exams, present college details, contact information, ID uploads, caste and income details, and academic history. Photograph upload is also required.

Uploaded by

Sunil RAYALASEEMA GRAPHICS
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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::ePASS::Fresh Registration 2015- http://apepass.cgg.gov.in/freshregister2016.do?

16:: studentAction=GetForm

Fresh Application Form (2015-16)


Student SSC Details
AP Regular AP Supplementary/Private CBSE ICSE
SSC Pass Type :*
Other Board AP OSS Oriental SSC Direct Degree

1 of 3 11/1/2015 8:11
SSC HallTicket No :* SSC Pass Year :*

Date of Birth :* DD-MM-YYYY

Student CET Details


ils
CET NONCET

CET :* CET Year :*

Enter CET HtNo. :* CET Rank :*

Date of Allotment :* DD-MM-YYYY

Present College Details


College District :* College Mandal :*

University / Board

College : *

Course :* Course Year :*

Mobile
ile No. Veri
erificat
cation
ion
Mobile No. Belongs to : Mobile Number :*

Student Father Mother

Upload Scanned Aadhar Card/UID :

studetn.jpg Yes No Yes No

Enter UID:* ●●●●●●●●●●●● Enter UID:* ●●●●●●●●●●●●


Have
Aadhaar No. Re-Enter UID:* 877306594824 Re-Enter UID:* 754767349311

Upload Scanned Aadhar Card/UID: Upload Scanned Aadhar Card/UID :

atehr.jpg mother.jpg

Have
PAN Card Yes No Yes No Yes No
No:

Have
four wheeler Yes No Yes No Yes No
vehicle:

Caste Details
Religion : Hindu

Caste : EBC(LISTED) Subcaste : KAPU

Ration Car
Card Details
Ration Card No.
Type
(Not mandatory):

Caste Certi
ertifficate for SC/ST/BC and Nativity Certif
tificat
cate for EBC/OC Minor
nority
ity /OC PHC
Mee Seva No. : * CGC011506743381

Mee Seva No. : * CGC011506743381 Approved Date : * 08/10/2015


KASIREDDY CHANDRA
Applicant Name : * KASIREDDY KALPANA Father Name : *
SEKHAR REDDY
ANANTHAPURAMU
District/State : * Mandal : * DHARMAVARAM
/Andhra
T.Narayana Moorthy
MRO Name : * Caste : * HINDU/KAPU (OC)
(FAC)

Income Certificat
cate Details
Mee Seva No. : * IC011505444008

Mee Seva No. : * IC011505444008 Approved Date : * 25/07/2015


K CHANDRA SEKHAR
Applicant Name : * K KALPANA Father Name : *
REDDY
District/State : * Ananthapuramu /Andhra Mandal : * Dharmavaram
T.Narayana Moorthy
MRO Name : * Total Income : * 60000.00
(FAC)
Academic
Class District Mandal Village School/College Name
Year

-- Select -- -- Select -- --Select--

--Select--

--Select--

--Select--

--Select--

--Select--

--Select--

Student Phot
hotograph
Image of your Passport Photograph : * No file selected.

@d esigned and developed by Centre for Good Governance.

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