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This document contains a registration form for a qualifying examination. It requests personal details like name, date of birth, category, address, contact information, education details, test center preferences, and payment details from the candidate. The candidate also has to give a declaration and signature.

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manideeph26
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51 views

Ap

This document contains a registration form for a qualifying examination. It requests personal details like name, date of birth, category, address, contact information, education details, test center preferences, and payment details from the candidate. The candidate also has to give a declaration and signature.

Uploaded by

manideeph26
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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3/19/24, 1:40 PM about:blank

1. Stream # : Engineering & Pharmacy


2. (a) Qualifying Examination : INTERMEDIATE (REGULAR) REGISTRATION NO. :
(b) Qualifying Exam Hall Ticket No.(Latest) # : 2413215640 A1410153438A
(c) Year of App./Passing the Qualifying Exam : 2024
(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 # : HANUMANTHU MANIDEEPH


(b) Father's Name # : HANUMANTHU SRINIVASA RAO
(c) Mother's Name : HANUMANTHU SRUJANA
(d) Date of Birth (as per SSC or Equivalent) # : 26/04/2007
(e) Gender : MALE
4. Category # : BC_A
5. Local Area : AU
6. (a) Non-Minority / Minority : Non-Minority
(b) Minority Category : N.A
7. Annual Income of the Parents (Rs.) : Above Rs 8 Lakhs
8. (a) Study Details :

Class-6 NTR Class-7 NTR


Class-8 NTR Class-9 NTR
Class-10 NTR Inter 1st year / Equivalent NTR
Inter 2nd year / Equivalent NTR
(b) 10+2 Studies : OTHER PRIVATE JUNIOR COLLEGES
(c) Place of Study - SSC or Equivalent : Urban
(d) SSC Hall Ticket Number & Year of Passing : 2212119564 , April - 2022
9. (a) Address for Correspondence : 76-8/1-16,BATTALA TATARAO STREET ,NETAJI HIGH SCHOOL
ROAD, BHAVANIPURAM,
VIJAYAWADA, NTR,
ANDHRA PRADESH, 520012
(b) Contact Telephone Number (Mobile) : 9866807488 (c) E-Mail Id : [email protected]
(d) Aadhar Card number / Enrolment number : 747859087611
10. Test Centre Preferences
Preference - 1 Preference - 2 Preference - 3
NTR - Vijayawada GUNTUR - Guntur VISAKHAPATNAM - Gajuwaka

Preference - 4 Preference - 5 Preference - 6


KAKINADA - Kakinada ELURU - Eluru ANAKAPALLE - Anakapalle
11. (a) Fee particulars - Payment through : ONLINE (c) Amount (in Rs.) : 567.70
(b) Payment Reference Id. : P141033123BA
# These fields CANNOT be edited by candidate. It will be done by Convener, AP EAPCET - 2024 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 - 2024 is not responsible in anyway.

Date : 19/03/2024 01:40 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
by a Gazetted Officer or the in the presence of the Invigilator
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 - 2024 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 - 2024

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