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0% found this document useful (0 votes)
9 views

243550485578_ApplicationForm (1)

Uploaded by

madhavtekriwal00
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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COMMON UNIVERSITY ENTRANCE TEST

CUET (UG) - 2024


Confirmation Page

Application Number 243550485578


Do Not Send this Page to National Testing Agency (NTA).
Candidate is requested to retain the printout of Confirmation page for future Reference.
यितगत योरा (Personal Details)
एबीसी आईडी (Abc ID) MADHAV JAIN 04
उमीदवार का नाम (Candidate उमीदवार की जम ितिथ
Madhav Jain 04-11-2006
Name) (Candidate Date of Birth)
िपता/अिभभावक का नाम माता/अिभभावक का नाम
Krishan Kumar Jain Deepty Gupta
(Father/Guardian Name) (Mother/Guardian Name)
िलंग (Gender) Male राटीयता (Nationality) Indian
Class Xii Admit Card पहचान संया (Identification
पहचान का कार (Identity Type) MD524071
Issued By The Board Number)
राय का अिधवास (State
वग (Category) General Haryana
Domicile)
या आप पीडयूडी उमीदवार ह  (Are you a PwD Candidate?) No
िपता/अिभभावक की योयता (Father िपता/अिभभावक का यवसाय
Post Graduate Business
/Guardian Qualification) (Father/Guardian Occupation)
माता/अिभभावक योयता (Mother माता/अिभभावक का यवसाय
Graduate Others
/Guardian Qualification) (Mother/Guardian Occupation)
या आपको मधुमेह ह  (Are you वािषक पािरवािरक आय (Annual
No Rs. 600001 – 700000
Diabetic?) Family Income)
या आप जु ड़वां ह और दोनों CUET-UG 2024 के िलए आवे दन कर
No
रहे ह (Are you twin and both applying for CUET-UG 2024)
िनवास की जगह (Place Of तैयारी का तरीका (Mode of
URBAN Self-study
Residence) Preparation)
योयता परीा म अययन का मायम
(Medium of Study in Qualifying English
Examination)
अय कोटा े णी िववरण (Other Quota Category Details)
या आप गरीबी रे खा से नीचे ह  (Do
या आप कमीरी वासी ह  (Are
you belong to Below Poverty Line No No
you Kashmiri Migrant ?)
?)
रा कािमक/पूव सै िनकों का वाड
एनसीसी कोटा के िलए दावा (Claim
(Ward of Defence Personnel / Ex- No No
for NCC Quota)
Servicemen)
खेल कोटा के िलए दावा (Claim for Sports Quota) No
या आप िवविवालय कमचारी के
वाड ह  (Are you a ward of No
University Employee ?)
संपक योरा वतमान पता (Contact Details Present Address)
Ground Floor C 21
पिरसर संया / नाम (Premises
Mayfield Garden Sector 50 े  (Locality) Sector 50
No./Name)
Gurugram Haryana
उप-मोहला (Sub-
Mayfield Garden दे श (Country) India
Locality(Optional))
राय/संघ (State/UT) Haryana िज़ला (District) Gurugram
िपन कोड (Pin Code) 122018 मेल पता (Email Address) [email protected]
कं टी कोड (Country Code) +91 मोबाइल नंबर (Mobile Number) 8287859113
वै किपक मोबाइल नंबर (Alternate
9214043422
Mobile Number)
थायी पता (Permanent Address)
Ground Floor C 21
पिरसर संया / नाम (Premises
Mayfield Garden Sector 50 े  (Locality) Sector 50
No./Name)
Gurugram Haryana
उप-मोहला (Sub-
Mayfield Garden दे श (Country) India
Locality(Optional))
राय/संघ (State/UT) Haryana िज़ला (District) Gurugram
िपन कोड (Pin Code) 122018
योयता िववरण (Qualification Details)
10वीं योयता िववरण (10th Qualification Details)
पिरणाम िथित (Result Status) Passed उीण वष (Passing of Year) 2022
बोड /िवविवालय का नाम
योयता परीा (Qualifying Exam) 10th Or Equivalent Cbse I (cbse International)
(Board/University Name)
कू ली िशा का थान (Place of कू ल/कॉलेज का कार (Type of
Urban Private Unaided
Schooling) School / College)
योयता परीा दे श (Qualifying Examination Country) India
योयता परीा राय (Qualifying योयता परीा िजला (Qualifying
Delhi North West Delhi
Examination State) Examination District)
कू ल/कॉलेज का नाम पता कू ल/कॉलेज िपनकोड
Sector 14 Rohini Delhi 110085
(School/College Name Address) (School/College Pincode)
रोल नंबर (Roll Number) 26123213
पिरणाम मोड (Result Mode) Percentage कुल अंक (Total Marks) 500.00
ात अंक(Obtained Marks) 396.00 ितशत % (Percentage %) 79.20
12वीं योयता िववरण (12th Qualification Details)
उीण वष /उपिथित (Passing of
पिरणाम िथित (Result Status) Appearing 2024
Year/Appearing)
बोड /िवविवालय का नाम
योयता परीा (Qualifying Exam) 12th Or Equivalent Cbse I (cbse International)
(Board/University Name)
कू ली िशा का थान (Place of कू ल/कॉलेज का कार (Type of
Urban Private Unaided
Schooling) School / College)
योयता परीा दे श (Qualifying Examination Country) India
योयता परीा राय (Qualifying योयता परीा िजला (Qualifying
Haryana Gurugram
Examination State) Examination District)
कू ल/कॉलेज का नाम पता कू ल/कॉलेज िपनकोड
Kr Manglam World School 122022
(School/College Name Address) (School/College Pincode)
रोल नंबर (Roll Number) 17649521
िवविवालय/ िवषय चयन (University / Subject Selection)
िवविवालय का नाम िवविवालय काय म का नाम
.सं. (S.No.) िवषय नाम (Subject Names)
(University Name) (University Program Name)
Any One From Section I + Mathematics/applied
1. University Of Delhi B. Com. (hons.) Mathematics/ Accountancy/book Keeping + Any
Two From Section Ii
Any One From Section I + Any Three From Section
2. University Of Delhi B. Com. Ii Or Any One From Section I+ Any One From
Section Ii + Section Iii
Bachelor Of Business
Any One From Section I + Mathematics/applied
3. University Of Delhi Administration (financial
Mathematics + Section Iii
Investment Analysis) [bba(fia)]
Bachelor Of Business Economics Any One From Section I + Mathematics/applied
4. University Of Delhi
[bbe] Mathematics + Section Iii
Babasaheb Bhimrao Section Ia Languages (any Of The Listed Languages
5. B.com (hons)
Ambedkar University May Be Chosen.) Section Iii - General Test
Guru Gobind Singh I. English (code 101)– Section Ia Languages Ii.
6. 4 Year B.com.(hons.)
Indraprastha University General Test (code 501) - Section Iii
I. English (code 101)- Section Ia: Languages Ii.
Guru Gobind Singh
7. 4 Year Bba & Allied Programmes General Test (code 501)- Section Iii Iii. Business
Indraprastha University
Studies(code 305) - Section Ii
Bachelor Of Management Studies Any One From Section I + Mathematics/applied
8. University Of Delhi
[bms] Mathematics + Section Iii
"section Ia (language) English Or Hindi Section Ii
(domain Subjects) Accountancy/book Keeping,
Agriculture, Anthropology, Biology/biological
Studies/biotecnology/biochemistry ,business Studies,
Chemistry, Environmental Studies, Computer
Five Year Integrated Programme Science/informatics Practices, Economics/business
9. University Of Allahabad
In Management (bba & Mba) Economics, Entrepreneurship, Geography/ Geology,
History, Home Science, Mass Media/mass
Communication, Mathematics / Applied
Mathematics, Physics, Political Science, Psychology,
Sociology (any One Domain Subjects From Above)
Section Iii (general Test)"
1. Subject Test – Accountancy/book Keeping (301)
B.com.(hons.) / B.com.(hons.) -
10. Banaras Hindu University 2. Subject Test – Business Studies (305) 3. General
fmm
Test (501)
"section Ia (language) English Or Hindi Section Ii
11. University Of Allahabad Bcom (domain Subjects) Accountancy/book Keeping
Section Iii (general Test)"
टे ट पे पर / िवषय चयन (Test Paper / Subject Selection)
टे ट पे पर / िवषय का मायम (Medium of Test Paper
.सं. (S.No.) परीा प (Test Paper) िवषय (Subject)
/ Subject)
1 Test Paper 1 English English
2 Test Paper 2 Accountancy/book Keeping English
3 Test Paper 3 Business Studies English
4 Test Paper 4 Economics/business Economics English
Mathematics / Applied
5 Test Paper 5 English
Mathematics
6 Test Paper 6 General Test English
परीा कद और िववरण (Exam Center And Details)
परीा कद के िलए िवकप
.सं. (S.No.) (Choice For Exam शहर का नाम (राय का नाम) (City Name (State Name))
Center)
1 1st Choice For Exam Center Gurugram ( Haryana )
2nd Choice For Exam
2 Delhi/new Delhi ( Delhi )
Center
3 3rd Choice For Exam Center Faridabad ( Haryana )
4 4th Choice For Exam Center Karnal ( Haryana )
उमीदवार ारा अपलोड की गई छिवयां (Images Upload by Candidate)

PHOTO

SIGNATURE

शु क भु गतान िववरण (Fee Payment Details)


भु गतान का कार (Payment Mode) Online लेन-दे न आईडी (Transaction ID) 033149
शु क जमा िकया गया (Fee
परीा शु क (Exam Fee) 2200 24-03-2024 19:27:10 PM
Submitted On)
शु क की पु िट ितिथ (Fee Confirmed भु गतान गे टवे का नाम (Payment
24-03-2024 19:28:31 PM HDFC
Date) Gateway Name)
घोषणा (Declaration)
म घोषणा करता हं ू िक आवे दन प म मे रे ारा दी गई जानकारी सभी कार से सय है और कुछ भी िछपाया नहीं गया है । यिद कोई िविट या जानकारी झठ ू ी पाई जाती
है , तो इससे मे रा वे श वत : र हो जाएगा और इसके अलावा म िवविवालय ारा उिचत समझी जाने वाली कारवाई के िलए भी उरदायी हो जाऊंगा। म एतद्ारा
वचन दे ता हं ू िक म ने कायम के िलए ॉपे टस म िनधािरत पाता शतों को यानपूवक पढ़ िलया है । म इस बात से सं तुट होने के बाद आवे दन कर रहा हं ू िक म पाता
शतों को पूरा करता हं ।ू यिद िकसी भी तर पर यह पाया जाता है िक म यूनतम िनधािरत मानदं ड को पूरा नहीं करता हं ,ू तो मे रा वे श, यिद िदया जाता है , र कर िदया
जाएगा और मु झे वे श का कोई अिधकार नहीं होगा। (I declare that information furnished by me in the application form is true in all respect and nothing is
concealed. In case any entry or information is found to be false, this shall entail automatic cancellation of my admission besides rendering me liable to such
actions as deemed fit by the University. I hereby undertake that I have carefully gone through the eligibility conditions prescribed in the prospectus for the
programme. I am applying after satisfying that I meet the eligibility conditions. If at any stage it is found that I do not fullfill the minimum prescribed
criteria, my admission, if granted, shall stand cancelled and I shall have no right to admission whatsoever.)
IP Address : 223.190.80.188 Date of Downloading : 24-03-2024 19:28:52 PM
Domain name : cuetug.ntaonline.in

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