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This document is a confirmation page for an online application to the JEE(Main)-2013 exam. It provides details of the applicant's exam registration including application number, exam details, personal information, and a declaration signed by the applicant and countersigned by a parent/guardian. The applicant is instructed to print this page, attach photographs and signatures, and mail it along with the original demand draft to confirm their application.
Iitjee
- 1. JEE(Main)-2013: Confirmation Page for Application Number :30518048 Page 1 of 1 Click Here to Print This Page Close CENTRAL BOARD OF SECONDARY EDUCATION, DELHI CONFIRMATION PAGE - JEE(Main) 2013 油油Application No. 30518048 油 You have successfully submitted Application On-line. Kindly take the printout of this page. Paste your two油recent油photographs,油put油left油hand油thumb油impression油 and sign in the specified box. Send the CONFIRMATION PAGE through Registered/ Speed Post only along with油original油Demand油Draft油(if油fee油paid油by油Demand油 Draft) so as to reach positively by 26/12/2012 in the CBSE office to Executive Director, JEE (Main) Secretariat, Central Board of Secondary Education, PS-1-2, Institutional Area, I.P.Extn. Patparganj, Delhi-110 092. Apply for JEE (Main) Paper - 1 & Paper 2 Both ( 3) Question Paper Medium ENGLISH Pen and Paper Based Mode of Exam Paper-1 PEN AND PAPER BASED EXAMINATION Mode of Exam Paper-2 Examination Exam Cities - JEE(Main) 1st : GUNTUR ( 802), 2nd : KHAMMAM ( 803), 3rd : WARRANGAL ( 805), 4th : TIRUPATI ( 804) Candidate's Name PRATTIPATI BUNNYMANUAL Date of Birth 07/05/1996 Mother's Name K VASANTHA Gender MALE Father's Name P ANANDA RAO Category GENERAL State of Eligibility ANDHRA PRADESH ( 02) Person with Disability No Mobile No. 9490880343 Is Blind Candidate No Email Id manuelm743@gmail.com Nationality INDIAN ANDHRA PRADESH BOARD OF INTERMEDIATE Board/University of Q.E. Q.E. Marks(%) EDUUCATION Name of Q.E. passed/appearing 01 Q.E. passing/appearing in 2013 Interested in JEE(Advanced) No DECLARATION: I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. I have read and understood the JEE procedures for both JEE (Main) and JEE(Advanced) 2013. I shall abide by the terms and conditions thereon. Complete Mailing Address in Capital Letters: 油 Name 油油 Address 油油 Left Hand Thumb Impression 油油 油 油油 油油 Pin Code: 油油 油油 油油 油油 油油 油油 油油 油油 油油 油油 油油 油 Signature of the Candidate(Not in capital letters) 油 Countersigned by Parent /Guardian Paste (do not staple) a recent Photograph duly Paste (do not staple) a attested by the recent unattested ATTESTATION BY HEAD OF THE INSTITUTION/GAZETTED Principal/Head of the Photograph OFFICER Institutions / Gazetted 油Photograph油must油not be This is to油certify油 that油 the油 particulars油 given油 in油 this CONFIRMATION Officer larger than this box PAGE including Name, Photograph, Address, Category, Date of Birth 油Photograph must not be 油 UNATTESTED and Signature are correct to the best of my knowledge and belief. larger than this box 油 油油ATTESTED 油 Signature of Principal/Head of the Instt./Gazetted Officer with date and Seal Details of Demand Draft (Write油Application油No.,油Name油at油the油back油of油Demand油Draft) Draft No. :877780 Amount:1400 Date of Issue:29/11/2012 Bank Name & Address:ANDHRA BANK, Tadigadapa, Vijayawada,Krishna,Andhra Pradesh Application No:30518048 http://jeemain.nic.in/jeemain2013/Online/ConfirmationPage.aspx 11/29/2012