Application No: 40240368/BTEC

General
Selected/Chance Memo/
Special Category Rank
ALIGARH MUSLIM UNIVERSITY
ONLINE PAYMENT

Session: 2019 - 2020 Roll No. : 0

Application Form for admission to
B.Tech
Faculty of Engineering & Technology

Bank: 530, CR No./Online Txn No.: 727147793, Date: 2019-02-26 14:23:01, Amount: 670.06 Nationality: INDIAN

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Preference for Test Centres:

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1. Aligarh 2. Lucknow
Personal Details:
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Name: SOHIL KHAN Father's Name: MUQEEM KHAN

Date of Birth: 23-10-2001 Mother's Name: BABY KHAN
Gender: MALE
Religion: Islam

Details of Qualifying Examination: Status & Special Categories:

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Examination: CENTRAL BOARD OF SECONDARY EDUCATION Status: External
Enrolment No.:
Roll No.: 5701209
Hall:
Year of Passing/Appearing: 2019 Special Categories: 1. NA 2. NA 3. NA
Board/Univ.: Central Board of Secondary Education, Delhi
Marks Obt./Max. Marks: 0/0
Remarks (if any):

Name of the Examination Board/University Year Roll No. % of Marks

12 TH CBSE BOARD 2019
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Permanent Address: Address for Correspondence:

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Address: VILLAGE POST - NADRAI Address: VILLAGE POST - NADRAI
KASGANJ KASGANJ
KASGANJ - 207123(UP) KASGANJ - 207123(UP)

Phone 1: 9997811311 Phone 2: Email ID: suhailmuqeem1@gmail.com

Is hostel accommodation required? YES (Hostel accommodation is not guaranteed; it is subject to availability of seats in the hostel)
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DECLARATION: I SOLEMNLY UNDERTAKE to accept and abide by the rules of the Aligarh Muslim University and all the decisions of the Academic
Council & other appropriate University bodies in regard to my admission. I hereby solemnly affirm that I have gone through the Guide to Admissions &
Supplements applicable for this course and solemnly declare on oath that the entries made by me in the above columns are true to the best of my
INE PAYMENT

knowledge and belief and if at any time, the entries are found incorrect, the admission may outrightly be cancelled and disciplinary action may be
initiated against me.
Application No: 40240368/BTEC

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Signature of the Candidate
Left Hand Thumb Impression (for All candidates)