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Delhi Skill and Entrepreneurship University

Government of NCT of Delhi

APPLICATION FORM
Payment ID:
pay_Jn9bYMSxLoXQps
Session 2022-2023
Order ID: Application Id:
order_Jn9aNNayE7tmwY DSEU001536230100

1. Personal Information:
Name: PRASHANT XX Date of Birth: 20-12-1995
Gender: Male Nationality : Indian
Program: Full Time/Part Time Persons with disability: No
Programs
Category : SC (SCHEDULED CASTE)
Are you a Defence Person: No Are you a Kashmiri Migrant: No
Blood Group: NOT KNOWN Applicant’s Occupation: Student
Family Income: Below 1.5 lakhs per annum Father’s Occupation: Private
Father’s Income: Below 1.5 lakhs per annum Father’s Highest Qualification: 10th
Mother’s Occupation: Home-maker Mother’s Income: Below 1.5 lakhs per annum
Mother’s Highest Qualification: No Formal Education Do you have a Letter of Recommendation: No
Are you a ward of DSEU Staff/ Faculty: No Do you have 2 years of work experience: No
Location of School/Institute Attended (For Delhi Location of School/Institute Attended (For Delhi
Class X) : Class XII):
Delhi Location of Not Applicable
Location of ITI/Institute Attended (For ITI): College/Polytechnic/University/Institute
Attended (For Diploma):
Location of College/University/Institute Not Applicable Appeared/Appearing for CUET? No
Attended (For Degree):
Yes Are you eligible for Tuition Fee Waiver in No
Is your guardian your parent?:
Private Polytechnics under BTE, Delhi?:
Are you eligible for Sikh Minority Quota at No
GTBPI under BTE, Delhi?:

2. Permanent Address:
Address Line 1: N-164, Krishan Vihar , Delhi
PIN/ZIP code: 110086 State: Delhi
District: NORTH WEST DELHI Emergency Mobile No: + 91 9210288279

3. Communication Address:
Address Line 1: N-164, Krishan Vihar , Delhi
PIN/ZIP code: 110086 State: Delhi
District: NORTH WEST DELHI
4. Registered Mobile No. 91 7042866356 5. Registered E-mail [email protected]
6. Family Details:
Father's Name: Laxman Prasad Mother's Name: Rukmani

7. Educational Qualification:
Name of MONTH/Year Roll No School PINCODE TYPE RTE SCHOOL Board/ Marks CGPA Percentage
Examination (Centre Quota FEE University
if Open PAID
School)
CBSE -
Central
Public or
10th / Equivalent 05/2012 8714137 Delhi 110086 No 240.00 Board of 7.6 / 10 72.2
Government
Secondary
Education
industrial
training
ITI (2 Years) in Affiliated to 1101 /
2020 R180807002941 institute 0.00 78.64
Electrician NCVT 1400
Jahangir
puri
Year 1 2019 536/700
Year 2 2020 582/700
12th / Equivalent
Diploma
Graduation
8. Class X Subjects and Marks:
S.N. Subject Type Obtained Marks Max Marks
1 English - Language and Literature Compulsory 8.00 10.00
2 Hindi Course-A Compulsory 8.00 10.00
3 Mathematics Compulsory 7.00 10.00
4 Science Compulsory 7.00 10.00
5 Social Science Compulsory 8.00 10.00
6 Sanskrit Compulsory 8.00 10.00
9. Class XII Subjects and Marks:
S.N. Subject Type Obtained Marks Max Marks
10. Course Type Opted for:
S.N. Course Type
1 Lateral Entry in Diploma Programs

11. Extra-Curricular Activities

S.N. Type of Activity Achievement Details Rank

Declaration/ Undertaking by the Candidate:

1. All the information given by me in this application is true and correct to the best of my knowledge, and I believe that nothing has been concealed.
2. I also undertake that if any of the above statements/information are found to be incorrect or false, or if any information or particulars are found to be
suppressed or omitted in the form, I am liable to be disqualified and my candidature/admission may be cancelled without any notice
3. I also undertake full responsibility for appearing for any tests/interviews/counselling sessions conducted as scheduled by the University for admission to
various courses. Failure to do so, will result in disqualification of my candidature.
4. I acknowledge that I am aware that there may be specific eligibility requirements for each program filling this form and appearing in the Entrance
Examination does not guarantee my admission in DSEU
5. I hereby undertake that I will abide by all the rules and regulations of the University and maintain discipline.
6. I further undertake that I will complete all the requirements of the curriculum which includes on-the-job training.
7. I will also comply with the rules and regulations/policies of the organization where I will be placed for on-the-job training.
8. In case I am unable to abide by the above-mentioned requirements, I am liable to loose Program credits.

Date: 29-06-2022

Printed on : 29-06-2022 09:04 AM

(Signature of the candidate)