Application for B.Sc.
(Hons) (Mathematics)
Registration No.: JMI2500100256 Application No. : 2500070634B54 ABC ID: Print On: 11-Sep-2025 06:39:25
Candidate Name Rahul
Father's/Guardian's Name DAYARAM
Mother's Name RAJBALA
Date Of Birth 18-Aug-2009
Gender Male
Mobile Number 7296948048
Email Id
[email protected]Domicile State Rajasthan
Nationality indian
Blood Group NA Religion Hinduism
------------------------------- The following information is only for statistical purpose -------------------------------
Reservation Category General Social Category OBC (Non-Creamy)
Do you belong to Jammu and
Are you a Kashmiri Migrant? No Kashmir?
No
N.C.C. Cadet No N.S.S. Volunteer No
Family Income Less than Rs.5,00,000/- EWS No
Are you PwD candidate? No
Have you ever been arrested/prosecuted/kept in detention/bound down/fined convicted by a court of Law or whether any case is
pending against you in a Court of Law? : No
Have you ever been debarred from any exam/rusticated by any University or any other educational instution or whether any case is
pending against you in any University or any other educational institute? : No
Any vigilance/Disciplinary case is pending against you? : No
Correspondence Address Permanent Address
Address Line 1 vpo dhani bari tehsil sidhmukh Address Line 1 vpo dhani bari tehsil sidhmukh
Address Line 2 dist churu rajasthan Address Line 2 dist churu rajasthan
District/City churu District/City churu
State Rajasthan State Rajasthan
Country India Country India
Pin Code 331701 Pin Code 331701
Mobile No 7296948048 Mobile No 7296948048
Academic Record
Max Obtd.
Degree/Certificate Board / Year of
Qualifications Marks/ Marks/ Marks(%) Status
Name University Passing
CGPA CGPA
Inter./Sr. Result
XII BSER AJMER 2025
Secondary Awaited
Matric/S.S.C. X BSER AJMER 2023 600 485 80.83 Passed Out
Test Centre Information
Test Centre Delhi
Payment details
Mode of Payment date of Payment Bank Ref. No. Amount
NET_BANKING 08-04-2025 10:59:52 250408224376908 700/-
UNDERTAKING
I hereby declare that all the particulars given in this application form by me are true and no fact has been suppressed or tempered. I have read the
Admission Prospectus 2025-2026 and the terms and conditions given therein and satisfied myself that I fulfill all the admission eligibility
requirements. In case any information furnished by me is found wrong, my candidature for admission be cancelled outright without giving any
opportunity and further that any disciplinary action be also taken against me.
Signature
