GOVERNMENT OF KARNATAKA

Office of the Commissioner for Public Instructions

Centralised Admission Cell
APPLICATION FORM FOR ADMISSION TO TWO YEAR B.Ed Course For the Year 2019-20

Personal Details
Application No 4012322 User Name Varija
Name VARIJA HEBBAR
DOB 3/12/1982 Gender Female
Father Name Sheshagiri Hebbar Mother Name Laxmi
Email ID Varija.hegde@gmail.co Mobile No 9480790142
m
Nodal Center N01 - Bangalore Urban

Permanent Address
Address 1093,3rd Main Road, 1st e Block, Rajajinagar 2nd Stage.
Near BBMP Ward office
Bangalore
North
Bangalore Urban
Karnataka
560010

Postal Address
Address 1093,3rd Main Road, 1st e Block, Rajajinagar 2nd Stage.
Near BBMP Ward office
Banglore
North
Bangalore Urban
Karnataka
560010
Reservation Details
Kannada Medium Yes Mother Tongue Kannada
Physically Challenged No Nature of handicap -
Are you Claiming No Category GM
reservation under any
social category
Caste RD Number - Claim HK No
HK Region - HK RD Number -
Karnataka/Non Karnataka Karnataka Special Group -
Income Range Below 2.5 Lakhs Annual Income 45000

Education Details
Passed SSLC Yes Passed PUC Yes
Passed JOC No
Under Graduate Details
Studied Degree Yes
Passed/Appeared for final Passed Degree BA
year and waiting for result

1
Admission Year 1999 Passed Year 2002
Langauage I Kannada Language II English
Optional I History Optional II Economics
Optional III Political Science
Univeristy KARNATAKA UNIVERSITY
Maximum Marks 1200 Obatained Marks 855
Percentage 71.25
Post Graduate Details
Studied PG No PG Passed Year 0
PG Subject University
PG Maximum Marks 0 PG Obtained Marks 0
Percentage 0
Choices of Institution (In the order of Preference)
Preference District Name Institution Type Institution Name
1 Bangalore UnAided Vivekananda College of Education
Urban
2 Bangalore Aided Al-Ameen College of Education
Urban
3 Bangalore Aided M.E.S. Teachers College
Urban
4 Bangalore Aided Dr.Ambedkar College of Education
Urban
5 Bangalore Aided Rajajinagar College of Education
Urban
6 Bangalore Aided Vijaya Teachers College (C.T.E)
Urban
7 Bangalore UnAided K.I.E.T College Of Education (B.Ed)
Urban
8 Bangalore UnAided Gowtham College of Education
Urban
9 Bangalore UnAided Basaveshwara College of Education
Urban
10 Bangalore Aided Sanjay Gandhi College
Urban
Payment Details
Order Id 21052019124142 Bank Ref. No. 9337842445703
Payment Status SUCCESS Payment Mode DC
Amount 300 Transation Date 2019-05-21

Declaration :-

I here by declare that the information provided by me is true and correct to the best of my
knowledge.I have read the contents and condition given in the notification and I confirm the same.I am aware
that, If any of the information provided in the application form is found to be false/Incorrect, Application is
liable to be rejected at any point of the time and my selection for the B.Ed Course is also liable to be cancelled
at any stage and action can be taken as per law.
Applicant Signature

5/21/2019 7:19:28 PM