MAULANA AZAD P.G. COLLEGE

Application Session

2019-21

Date Of Application

Select Course

JOINT ENTRANCE EXAMINATION B.Ed. 2018 DETAILS

B.Ed. Registration No*

B.Ed. Roll No*

Group Applied*

Total Marks Obtained*

B.Ed. General Rank*

Examination Center/Code*

Name*

First Name*

Middle Name

Last Name

Father's Name*

Mother's Name*

Date Of Birth

Mobile*

+91

Phone

E Mail*

Religion

Category

Special Category

Gender

Marital Status

Handicap

No Yes

If Yes, Select Category

Correspondence Address

Street Address*

Police Station (Thana)*

State

City

Pincode*

Permanent Address
Same as above

Street Address*

Police Station (Thana)*

State

City

Pincode*

Photo ID Proof

Adhaar Number*

Educational Details

Exam	Name of Board/University	Name of School/College	Year of Passing	Roll No	Marksheet Serial No	Total Marks	Obtained Marks	Percentage
High School
Intermediate
Graduation
Post-Graduation

Note: Write NA if you don't have Roll No or Marksheet Number

Note

फोटो अपलोड करने से पहले ऊपर भरी गयी प्रविष्टयों को सावधानी पूर्वक जांच लें। यदि समस्त प्रविष्टया सही है तो फोटो अपलोड करें। Before proceeding to upload the photo , Please carefully check the above entries. If details are correct then proceed to upload your photo.

MAULANA AZAD P.G. COLLEGE

Baital-Quadirabad, Siddharth Nagar, U.P.

Affiliated To: Siddharth University, Kapilvastu, Siddharth Nagar

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JOINT ENTRANCE EXAMINATION B.Ed. 2018 DETAILS