A181064145BF .pdf

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1. Stream #

: Engineering (E)

2. (a) Qualifying Examination
(b) Qualifying Exam Hall Ticket No.(Latest) #
(c) Year of App./Passing the Qualifying Exam
(d) Medium of Instruction at Qualifying Exam
(e) Urdu Translation
(f) Place of Study - Intermediate or Equivalent
(g) Bridge Course Hall Ticket No. (if any)

:
:
:
:
:
:
:

INTERMEDIATE (REGULAR)
1805233554
2018
English
NO
Urban

3. (a) Candidate's Name #
(b) Father's Name #
(c) Mother's Name
(d) Date of Birth (as per SSC or Equivalent) #
(e) Birth State, Birth District
(f) Gender
4. Category #
5. Local Area
6. (a) Non-Minority / Minority
(b) Minority Category
7. Annual Income of the Parents (Rs.)
8. (a) Study Details

:
:
:
:
:
:
:
:
:
:
:

VISHNUBHOTLA SRIRAMA KUMAR
VISHNUBHOTLA LAKSHMI NARASIMHA MURTHY
VISHNUBHOTLA ARUNDHATHI
07/12/2000
ANDHRA PRADESH - GUNTUR
Male
OC
AU
Non-Minority
N.A
More than Two Lakhs

REGISTRATION NO. :

A181064145BF

Class-6

KRISHNA

Class-7

KRISHNA

Class-8

KRISHNA

Class-9

KRISHNA

Class-10

KRISHNA

Inter 1st year / Equivalent

KRISHNA

Inter 2nd year / Equivalent

KRISHNA

(b) 10+2 Studies
(c) Place of Study - SSC or Equivalent
(d) SSC Hall Ticket Number & Year of Passing
9. (a) Address for Correspondence

:
:
:
:

(b) Contact Telephone Number (Mobile)
(d) Aadhar Card number / Enrolment number
10. Test Centre Preferences

: 9491828298
: 777897554105

Districts
KRISHNA

OTHER PRIVATE JUNIOR COLLEGES
Urban
1612108018 , March - 2016
DOOR NO. 23-33-15, VANAPALAVARI STREET, NEAR AMALI
SCHOOL, SATYANARAYANAPURAM,
VIJAYAWADA, KRISHNA,
ANDHRA PRADESH, 520011
(c) E-Mail Id : canopusx@vivaldi.net

Preference - 1

Preference - 2

Vijayawada

11. (a) Fee particulars - Payment through
(b) Payment Reference Id.

Kanchikacherla
: ONLINE
: P18109503776

Preference - 3
Mylavaram

(c) Amount (in Rs.) : 559.00

# These fields CANNOT be edited by candidate. It will be done by Convener, AP EAMCET - 2018 Office (email to apeamcet18@gmail.com), 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 (i.e 08.04.2018 to 12.04.2018). For any details contact 0884-2340535 (or) 2356255

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 EAMCET-2018 is not responsible in anyway.

Date :

09/04/2018 07:10 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
by a Gazetted Officer or the
Principal of the College where
studied (Well in advance
BEFORE EXAMINATION)

Note :

SIGNATURE OF THE CANDIDATE
in the presence of the Invigilator
Left Thumb Impression

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 EAMCET-2018 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 EAMCET-2018


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