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Any Bachelor Degree of 3/4/5 Years Duration: Preserve The Registration Number For All Future Correspondence

This document contains registration information for the AP ICET 2021 entrance exam. It includes: 1) Personal details of the candidate such as name, father's name, date of birth, address, contact information. 2) Education details - qualifying degree, place and years of study from class 9 onwards. 3) Category, annual family income, test center preferences. 4) Payment details - the candidate paid 606.37 online and received a payment reference ID. 5) A declaration by the candidate that they have read the instructions, will abide by regulations, and have provided truthful information. They will sign and provide a thumb impression on the day of the exam.

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Ranjith Kumar
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77 views1 page

Any Bachelor Degree of 3/4/5 Years Duration: Preserve The Registration Number For All Future Correspondence

This document contains registration information for the AP ICET 2021 entrance exam. It includes: 1) Personal details of the candidate such as name, father's name, date of birth, address, contact information. 2) Education details - qualifying degree, place and years of study from class 9 onwards. 3) Category, annual family income, test center preferences. 4) Payment details - the candidate paid 606.37 online and received a payment reference ID. 5) A declaration by the candidate that they have read the instructions, will abide by regulations, and have provided truthful information. They will sign and provide a thumb impression on the day of the exam.

Uploaded by

Ranjith Kumar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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7/22/2021

1. (a) Qualifying Degree Examination : ANY BACHELOR DEGREE OF 3/4/5 YEARS DURATION Preserve the Registration Number for
(b) Qualifying Degree Exam Hall Ticket No # : 0219002024 all future correspondence.
(c) Year of App./Passing the Qualifying Exam : 2019 REGISTRATION NO. : 5110053172
(d) Medium of Instruction at Qualifying Exam : English
(e) Place of Study - Intermediate or Equivalent : Rural
2. (a) Candidate's Name # : SAIJALA KURUBA RANJITH KUMAR
(b) Father's Name # : SAIJALA KURUBA NAGARAJU
(c) Mother's Name : SAIJALA KURUBA NAGALAXSHMI
(d) Date of Birth (as per SSC or Equivalent) # : 16/06/2001
(e) Birth State, Birth District : ANDHRA PRADESH - ANANTAPUR
(f) Gender : Male
3. Category : BC_B
4. Local Area
: SVU
5. (a) Non-Minority / Minority : Non-Minority
(b) Minority Category : N.A
6. Annual Income of the Parents (Rs.) : Below One Lakh
7. (a) Study Details
Class-9 ANANTAPUR Class-10 ANANTAPUR
Inter 1st year / Equivalent CHITTOOR Inter 2nd year / Equivalent CHITTOOR
Degree 1st year CHITTOOR Degree 2nd year CHITTOOR
Degree 3rd year CHITTOOR
(b) Place of Study - SSC or Equivalent : Rural
(c) SSC Hall Ticket Number & Year of Passing : 1623124199 , March - 2016
(d) Inter Hall Ticket Number & Year of Passing : 1809246409 , March - 2018
8. (a) Address for Correspondence : 1/, AVULENNA,
BELUGUPPA, ANANTHAPUR,
ANDHRAPRADESH, 515741
(b) Contact Telephone Number (Mobile) : 9676788772
(c) E-Mail Id
:
[email protected]

(d) Aadhar Card number : 884373691707


9. Test Centre Preferences
Districts Preference - 1 Preference - 2 Preference - 3
ANANTAPUR Anantapur Gooty Tadipatri
CHITTOOR Tirupati Madanapalle Chittoor
10. (a) Fee particulars - Payment through : ONLINE
(c) Amount (in Rs.)
:
606.37

(b) Payment Reference Id. : P51101159821


# - These Fields CANNOT be edited by candidate, but written
request can be made to the CONVENER or Regional Coordinator of AP ICET - 2021 or email
to
[email protected]
Remaining fields can be edited by the candidate during the permitted period. For
any details contact at 0891-8541866.

Declaration : 1) I have carefully gone through the instruction booklet and I am conversant with
the instructions. I shall abide by the eligibility conditions
and other regulations
to be satisfied for appearingat the entrance test and admission into any course
prescribed. Further, I assure that, I will not
involve in any malpractise or illegal
activities in the entrance test. In case, I have furnished any false information
or involved in any
malpractise or illeagal activities, I am liable for punishment
as per the existing law.
2) I am responsible for the corrections of the above details filling by me
and the CONVENER AP ICET-2021 is not responsible in
anyway.
Date : 22/07/2021 05:02 PM
SIGNATURE and LEFT HAND THUMB impression of the candidate to be done in the presence
of the Invigilator
Affix a recent color on the day of Examination in the Examination Hall
photograph (3.5 cmX3.5 cm)
and get attested by a Gazetted SIGNATURE OF THE CANDIDATE
Officer
or the Principal of the in the presence of the Invigilator Left Thumb Impression
College where studied (Well
in advance BEFORE
EXAMINATION)

Note : 1) ALL the candidates have to submit this form in the Examination
Hall to the Invigilator.
2) Candidates are not allowed into the Examination Hall
even if they are LATE BY A MINUTE.
3) This is computer Generated sheet and does not require the signature of the CONVENER,
AP ICET-2021

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