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Application Form
JNU Entrance Examination
2013-14

Jawaharlal Nehru University, New Delhi

GENERAL DETAILS
Registration No.: 28044
Application Form No.: 850410
Candidate Name: ARCHANA SAHU
Father's/ Husband's/
SHYAM LAL SAHU
Guardian's Name :
Date of Birth : 26 Mar 1991 Photo
Gender : Female
Nationality: Indian
Category: OBC (Only Non Creamy Layer) Signature
Minority: No
State of Domicile : Uttar Pradesh
Is Below Poverty Line : No
IS PH: No PH Category: N/A
Is Leprosy Affected Person Are you a Kashmiri Migrant
No No
: :
Do you belong to Defence
No
Personnel Category :
Are you Student of Any
Yes
Other University
Name of Other University allahabad university Name of Course m.sc.
Are you Student of JNU No
Name of School : Name of Program :
Programme for Study : M.Phil./Ph.D., M.Tech./Ph.D., Pre-Ph.D./Ph.D., M.P.H./Ph.D.
Mode of Payment Credit/Debit Card Rs./- 420.00
Chioce of Field of Study in order of preference
Pre-Ph.D./Ph.D. in Mathematical
First Preference Second Preference N/A
Sciences (MATP)-160
Third Preference N/A
Year in which 10+2 or
Entrance Exam Centre
equiv. exam 2011 Allahabad
Code
passed/appearing
Quartile State : N/A District Quartile N/A
Contact Details
Telephone No.: Fax No.:
Mobile No.: 9450626699 Email ID: skgcp86@gmail.com
Mailing Address Details Permanent Address Details
Address: 133 4c,3 teliarganj Address: kilahanapur kunda pratapgarh
State: Uttar Pradesh State: Uttar Pradesh
Pin Code : 211004 Pin Code : 230201

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JNU http://jnuonline.in/PrintForm.aspx

Academic Record
% of
Name of
Marks/ Duration
S. Year of School/ Name of
Examination Passed CGPA** of District Subject/Papers Offered
No. Passing College/ Board/University
/Grade Course
Institution
Points
High
JNV
1 School/Matriculation/10th 2006 80.8 1 PRATAPGARH CBSE HINDI,SCIENCE,ENGG,SOCALSCIENCE,MATH
PRATAPGARH
Class
Senior School Certificate
JNV
2 (10+2) Intermediate or 2008 74.6 2 PRATAPGARH CBSE HINDI,ENGG,MATH,PHY,CHEM
PRATAPGARH
equivalent
ALLAHABAD ALLAHABAD
3 B.Sc. 2011 65.6 3 ALLAHABAD MATH,PHY,PHOTOGRAPHY
UNIVERSITY UNIVERSITY
4 Any other Examination 0 0 0

DECLARATION BY THE APPLICANT


I declare that the information furnished by me in the Application Form is true in all respects and in case any entry or
information is found to be false, this shall entail automatic cancellation of my admission besides rendering me liable to such
action as the University may deem proper. I hereby undertake that I have carefully gone throught eligibility conditions
prescribed in the prospectus for the porgramme I am applying for and shall appear in the entrance examination after
satisfying myself that I do fulfill the same. If at any stage it is found that I do not fulfil the minimum prescribed eligiblility
criteria, my admission, if granted, shall stand cancelled and I shall have no right to admision whatsoever. I also declare that I
have not been debarrred from taking admission in JNU neither have I been declared out or bound from JNU Campus.

Signature

ARCHANA SAHU (850410)


Instructions
Before mailing the confirmation page, the candidate is required to ensure that

1. Kindly ensure the clarity of photograph and signature that you have uploaded.
2. The candidate has signed the confirmation page.
3. The candidate has enclosed the copy of the Fee Acknowledgement Slip.
4. The confirmation page is to be dispatched to the university by Registered Post/Speed Post only.
5. The confirmation page sent by courier services will not be accepted.
6. Last date for receipt the confirmation page is 2nd April 2013 up to 5:00 PM.

Please send the Confirmation Page only by Registered Post/Speed Post to:

SECTION OFFICER (ADMISSIONS),


Room No. 28, Administrative Block,
Jawaharlal Nehru University,
New Delhi 110067

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