[ College Copy ]
Chaudhary Charan Singh University, Meerut
Application Form for Admission in Minority Colleges/Institutions : 2025-26
1. Course Applied For : B.Ed. in minority college
2. Name of the Candidate : JYOTI GODIYAN
3. Father`s Name : DEVENDER KUMAR
Form No:25650382
4. Mother`s Name : SHEELA DEVI
5. Date of Birth : 05/03/1999 6. Gender : Female
7. Original Resident of : Other State 8. Kashmiri : No
9. Category : SC
Photograph attested by The
10. Belongs to Minority : No
Principal or any Gazetted Officer
11. State from where Graduated : DELHI
12. Do you have Domicile Cert. of U.P. State : No 13. Marital Status : Unmarried
14. Permanent Address : HOUSE NO E 10 294A STREET NO 10 AMAR COLONY
EAST GOKAL PUR, DELHI, GOAL PUR, Pin : 110094
15. Present Address : HOUSE NO E 10 294A STREET NO 10 AMAR COLONY EAST
GOKAL PUR, DELHI, GOAL PUR, Pin : 110094
16. Mobile No. (Candidate) : 9773827488
Mobile No. (Parent) : 9773827488 Signature of Candidate
Mobile No. (Friend) : 9773827488
17. Email ID :
[email protected]Your College Preferences
1. SHRI VINAYAK COLLEGE OF EDUCATION BAGHPAT
2. MURTI DEVI MEMORIAL COLLEGE, PILANA, BAGHPAT
3. LAKHMI CHAND PATWARI COLLEGE OF EDU., KHEKRA (BAGHPAT)
4. SYADWAD INSTT. OF HIGHER EDU. & RESEARCH, BAGHPAT
5. R S COLLEGE OF EDUCATION BAGHPAT
18. Description of Examination & Academic Score :
Name of Year Name of the School/College Name Subject Offered Mrks Max. Per.(%) Acad.
Examination Board/University obt. Mrks Scores
High School 2014 CBSE BOARD KEN VIDY NEW CENTER HINDI ENG MATH 256 500 51.20 3
VIGYAN VIHAR DELHI SCIENCE SOCIAL
SCIENCE
Intermediate 2017 CBSE BOARD KEN VIDY NEW CENTER ENG HINDI HISTORY GEO 304 600 50.67 3
VIGYAN VIHAR DELHI POL SCI
Graduation BA 2020 UNIVERSITY OF UNIVERSITY OF DELHI Science Stream 570 1200 47.50 5
DELHI
Post Graduation MA 2023 INDIRA GANDHI INDIRA GANDHI HINDI 477 800 59.63 11
NATIONAL OPEN NATIONAL OPEN
UNIVERSITY UNIVERSITY
Total Score 22
19. Checklist (Attached Documents)
Marksheet of High School : Yes Marksheet of Intermediate : Yes Marksheet of Graduation : Yes
Marksheet of Post Graduation : Yes Residence/Domicile Certificate : No Handicap Certificate : No
Caste Certificate :Yes Mark Sheet of B.Ed/Equivalents : No
Any other certificate 1. 2.
Detail of Registration Fee
Total Fees : Rs. 115/- Payment Status : PAID Transaction No. : 152be421cbc645b544b9 Date : 22/09/2025
Declaration : I JYOTI GODIYAN(25650382) hereby declare that I have read the eligibility conditions given in Information Brochure very carefully and I
undertake the responsibility of fulfilling eligibility conditions. The entries in the form are correct to the best of my knowledge and belief. If any entry is
found to be wrong or false, my admission may be cancelled at any time. I will pay all dues in accordance with the University rules and regulations and
also abide by the rules of conduct, behavior and studies
Undertaking : I, JYOTI GODIYAN D/o Shri. DEVENDER KUMAR , undertake not to involve directly or indirectly, in any kind of ragging.
Date:___________________
Place:___________________ (Full Signature of the Applicant)
Page 1/2
[ University Copy ]
Chaudhary Charan Singh University, Meerut
Application Form for Admission in Minority Colleges/Institutions : 2025-26
1. Course Applied For : B.Ed. in minority college
2. Name of the Candidate : JYOTI GODIYAN
3. Father`s Name : DEVENDER KUMAR
Form No:25650382
4. Mother`s Name : SHEELA DEVI
5. Date of Birth : 05/03/1999 6. Gender : Female
7. Original Resident of : Other State 8. Kashmiri : No
9. Category : SC
Photograph attested by The
10. Belongs to Minority : No
Principal or any Gazetted Officer
11. State from where Graduated : DELHI
12. Do you have Domicile Cert. of U.P. State : No 13. Marital Status : Unmarried
14. Permanent Address : HOUSE NO E 10 294A STREET NO 10 AMAR COLONY
EAST GOKAL PUR, DELHI, GOAL PUR, Pin : 110094
15. Present Address : HOUSE NO E 10 294A STREET NO 10 AMAR COLONY EAST
GOKAL PUR, DELHI, GOAL PUR, Pin : 110094
16. Mobile No. (Candidate) : 9773827488
Mobile No. (Parent) : 9773827488 Signature of Candidate
Mobile No. (Friend) : 9773827488
17. Email ID :
[email protected]Your College Preferences
1. SHRI VINAYAK COLLEGE OF EDUCATION BAGHPAT
2. MURTI DEVI MEMORIAL COLLEGE, PILANA, BAGHPAT
3. LAKHMI CHAND PATWARI COLLEGE OF EDU., KHEKRA (BAGHPAT)
4. SYADWAD INSTT. OF HIGHER EDU. & RESEARCH, BAGHPAT
5. R S COLLEGE OF EDUCATION BAGHPAT
18. Description of Examination & Academic Score :
Name of Year Name of the School/College Name Subject Offered Mrks Max. Per.(%) Acad.
Examination Board/University obt. Mrks Scores
High School 2014 CBSE BOARD KEN VIDY NEW CENTER HINDI ENG MATH 256 500 51.20 3
VIGYAN VIHAR DELHI SCIENCE SOCIAL
SCIENCE
Intermediate 2017 CBSE BOARD KEN VIDY NEW CENTER ENG HINDI HISTORY GEO 304 600 50.67 3
VIGYAN VIHAR DELHI POL SCI
Graduation BA 2020 UNIVERSITY OF UNIVERSITY OF DELHI Science Stream 570 1200 47.50 5
DELHI
Post Graduation MA 2023 INDIRA GANDHI INDIRA GANDHI HINDI 477 800 59.63 11
NATIONAL OPEN NATIONAL OPEN
UNIVERSITY UNIVERSITY
Total Score 22
19. Checklist (Attached Documents)
Marksheet of High School : Yes Marksheet of Intermediate : Yes Marksheet of Graduation : Yes
Marksheet of Post Graduation : Yes Residence/Domicile Certificate : No Handicap Certificate : No
Caste Certificate :Yes Mark Sheet of B.Ed/Equivalents : No
Any other certificate 1. 2.
Detail of Registration Fee
Total Fees : Rs. 115/- Payment Status : PAID Transaction No. : 152be421cbc645b544b9 Date : 22/09/2025
Declaration : I JYOTI GODIYAN(25650382) hereby declare that I have read the eligibility conditions given in Information Brochure very carefully and I
undertake the responsibility of fulfilling eligibility conditions. The entries in the form are correct to the best of my knowledge and belief. If any entry is
found to be wrong or false, my admission may be cancelled at any time. I will pay all dues in accordance with the University rules and regulations and
also abide by the rules of conduct, behavior and studies
Undertaking : I, JYOTI GODIYAN D/o Shri. DEVENDER KUMAR , undertake not to involve directly or indirectly, in any kind of ragging.
Date:___________________
Place:___________________ (Full Signature of the Applicant)
Page 2/2
