UPBED - 2014: Complete Application for Registration Number :412201373 http://upbed.nic.in/UPBEDAPP/appauth/UPBEDConfirmationPage.

aspx

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COMPLETE APPLICATION FORM : JEE B.Ed.-2014

Registration No.412201373

/
e-Receipt

. . - 2014,

A4 Address slip " ,

, I.T.H.M. ,

-284128 " /

18.03.2014

, ,

A-Personal Detail
Name of Candidate
Gender

RAJKUMAR
MALE

Married

YES

Nationality
Father's Name
Date of Birth

INDIAN
DAYARAM SINGH
25/07/1992

Religion

HINDU

Paper-II(Group)

SCIENCE

Category
Mother's Name
Parent's Annual Income
Examination city option

OTHER BACKWARD CLASS(OBC)

SHAKUNTALA DEVI
36000
1. MORADABAD

Sub-Category

NOT APPLICABLE

Domicile of UP
2. BAREILLY

U.P.
3. GHAZIABAD

B-Qualifying Exam Detail

Class
Graduation
Post Graduation

University/College
Year
MJP ROHILKHAND UNIVERSITY BAREILLY2013
NA
NA

Graduation with Sanskrit

Weightage Type

NO
N/A

MarksTotal Marks
677 1350
NA NA

Paper-I
Weightage

Percentage
50
NA

GENERAL KNOWLEDGE, HINDI

0

C-Details of Application Fee

Transaction No. :

IK46087364

Payment Mode:

(SBI )SB-MOPS

Amount:

1000

27032014 12:59:16

Date:

D-Mailing Address:
Name:
Address:

RAJKUMAR
VILLAGE MALPUR KHAIYAA
POST CHHAJLET
TEHSIL KANTH

District:
State:
PinCode:
Email ID:

MORADABAD

Mobile No.

8193845195

UTTAR PRADESH
244001
BUDDYSMBD@GMAIL.COM

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..-2014 (Information) - :

2.
3.
,

4.

..-2014

5.

Signature or Thumb Impression of Parent / Guardian

Left Thumb Impression of Candidate

Signature of the Candidate

245fc2544f99374b6ba64b4308524d8e 3/27/2014 1:28:50 PM

Address Slip
Joint Entrance Examination B.Ed.-2014

3/27/2014 1:26 PM

UPBED - 2014: Complete Application for Registration Number :412201373 http://upbed.nic.in/UPBEDAPP/appauth/UPBEDConfirmationPage.aspx

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Registration No: 412201373 ( Category:-Other Backward Class(OBC) )

CHECKLIST:
1. PHOTO PASTED
2. SIGNATURE OF CANDIDATE
3. LEFT HAND THUMB IMPRESSION OF CANDIDATE
4. SIGNATURE OR THUMB IMPRESSION OF PARENT / GUARDIAN
5. COPY OF E-RECEIPT

To,
The Coordinator,
Joint Entrance Exam B.Ed. 2014,
Institute of Tourism and Hotel Management, I.T.H.M.
Building,
Bundelkhand University,
Kanpur Road, Jhansi - 284128

From,
Name RAJKUMAR
C/o DAYARAM SINGH
Address VILLAGE MALPUR KHAIYAA
POST CHHAJLET
TEHSIL KANTH
City MORADABAD
State UTTAR PRADESH
Pin Code 244001

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3/27/2014 1:26 PM