Scribd
Upload
122 views

Application Form

1. This document contains registration information for the AP EAPCET-2023 entrance exam for M Hemanth Kumar Reddy to study Engineering & Pharmacy. 2. It provides personal details like name, father's name, date of birth, gender, category, address, contact information, education history, preferred test centers and payment details. 3. The candidate declares that he has read the instructions, will abide by regulations and not engage in malpractice for the entrance exam.

Uploaded by

Niharika Rangasamudram
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
122 views

Application Form

1. This document contains registration information for the AP EAPCET-2023 entrance exam for M Hemanth Kumar Reddy to study Engineering & Pharmacy. 2. It provides personal details like name, father's name, date of birth, gender, category, address, contact information, education history, preferred test centers and payment details. 3. The candidate declares that he has read the instructions, will abide by regulations and not engage in malpractice for the entrance exam.

Uploaded by

Niharika Rangasamudram
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

3/12/23, 8:55 PM about:blank

1. Stream # : Engineering & Pharmacy


2. (a) Qualifying Examination : INTERMEDIATE (REGULAR) REGISTRATION NO. :
(b) Qualifying Exam Hall Ticket No.(Latest) # : 2309242226 A13100530857
(c) Year of App./Passing the Qualifying Exam : 2023
(d) Medium of Instruction at Qualifying Exam : English
(e) Urdu Translation : NO
(f) Place of Study - Intermediate or Equivalent : Urban
(g) Bridge Course Hall Ticket No. (if any) :
3. (a) Candidate's Name # : M HEMANTH KUMAR REDDY
(b) Father's Name # : M CHENNA REDDY
(c) Mother's Name : M ANANDHAMMA
(d) Date of Birth (as per SSC or Equivalent) # : 11/07/2006
(e) Gender : MALE
4. Category # : OC
5. Local Area : SVU
6. (a) Non-Minority / Minority : Non-Minority
(b) Minority Category : N.A
7. Annual Income of the Parents (Rs.) : Above Rs 2.5 Lakhs and below Rs 8 Lakhs
8. (a) Study Details :

Class-6 Chittoor Class-7 Chittoor


Class-8 Chittoor Class-9 Chittoor
Class-10 Chittoor Inter 1st year / Equivalent Chittoor
Inter 2nd year / Equivalent Chittoor
(b) 10+2 Studies : OTHER PRIVATE JUNIOR COLLEGES
(c) Place of Study - SSC or Equivalent : Urban
(d) SSC Hall Ticket Number & Year of Passing : 2118130994 , June - 2021
9. (a) Address for Correspondence : 1-2, THAMATAMVARI PALLI,
SODAM, Chittoor,
ANDHRA PRADESH, 517234
(b) Contact Telephone Number (Mobile) : 8790304115 (c) E-Mail Id : [email protected]
(d) Aadhar Card number / Enrolment number : 290770320169
10. Test Centre Preferences
Preference - 1 Preference - 2 Preference - 3
TIRUPATI - Tirupati CHITTOOR - Chittoor TIRUPATI - Puttur
11. (a) Fee particulars - Payment through : ONLINE (c) Amount (in Rs.) : 614.16
(b) Payment Reference Id. : P13101103785
# These fields CANNOT be edited by candidate. It will be done by Convener, AP EAPCET - 2023 Office (email to [email protected]), subject to thorough verification of the Valid Documents and Approval by the
Committee.
Remaining fields can be edited by the candidate during the permitted period.

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 appearing at 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 EAPCET-2023 is not responsible in anyway.

Date : 12/03/2023 08:54 PM

SIGNATURE and LEFT HAND THUMB impression of the candidate to be done in the presence of the Invigilator on the day of
Examination in the Examination Hall
Affix a recent color photograph
(3.5 cmX3.5 cm) and get attested SIGNATURE OF THE CANDIDATE
in the presence of the Invigilator
by a Gazetted Officer or the Left Thumb Impression
Principal of the College where
studied (Well in advance
BEFORE EXAMINATION)

Note : 1) The candidate has 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) The candidate does not have option of choosing specific date / session to appear for the AP EAPCET-2023 entrance examination. This information is known to
him / her only after downloading Hall Ticket. For any reason if the candidate fails to appear in the given slot, he/she is treated as absent.
4) This is computer Generated sheet and does not require the signature of the CONVENER, AP EAPCET-2023

about:blank 1/1

You might also like