application form of higher secondary exam

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Home Application details of Registration-Id: 51102353538 for Combined Higher Secondary Level Examination - 2014 PART - I Examination Centre CR - Gorakhpur(3007) Name RISHI DEVAGAN Gender Male Date of Birth 06-06-1992 Father's Name NITIN KUMAR SRIVASTAV Mother's Name ASHA LATA SRIVASTAVA Nationality Indian Physically Handicapped No Whether Cerebral Palsy Community General Fee Exemption Claimed No Whether Ex-Serviceman No Whether belong to Minority Community No Age Relaxation Claimed No Email ID [email protected] Postal Address TARA PRINTING PRESS SUBHASH CHOWK PADRAUNA KUSHINAGAR Uttar Pradesh - 274304 Mobile: 8931087364 Skill Medium English Prefrence for Posts L D Educational Qualification Subject % of Marks Medium BCA Computer Application 74.63 English PART - II [ Fee Payment Details, Photograph & Signature of Registration-Id: 51102353538] Fee Payment Details (Subject to verification) Registration-Id Transaction-Id Transaction Date Fee Paid (in Rs) Agency Name Mode of Payment 51102353538 IK53747116 21-07-2014 100 State Bank of India Internet Banking SSC - Candidate's Application Details (Registration-Id: 51102353538) http://ssconline.nic.in/viewapplication.php 1 of 2 21-07-2014 15:32

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Page 1: Application Form of Higher Secondary Exam

Home

Application details of Registration-Id: 51102353538 for Combined Higher Secondary LevelExamination - 2014

PART - I

Examination Centre CR - Gorakhpur(3007)

Name RISHI DEVAGAN

Gender Male

Date of Birth 06-06-1992

Father's Name NITIN KUMAR SRIVASTAV

Mother's Name ASHA LATA SRIVASTAVA

Nationality Indian

Physically Handicapped No

Whether Cerebral Palsy

Community General

Fee Exemption Claimed No

Whether Ex-Serviceman No

Whether belong to Minority Community No

Age Relaxation Claimed No

Email ID [email protected]

Postal Address

TARA PRINTING PRESSSUBHASH CHOWKPADRAUNAKUSHINAGARUttar Pradesh - 274304Mobile: 8931087364

Skill Medium English

Prefrence for Posts L D

Educational Qualification Subject % of Marks Medium

BCA Computer Application 74.63 English

PART - II[ Fee Payment Details, Photograph & Signature of Registration-Id: 51102353538]

Fee Payment Details (Subject to verification)

Registration-Id Transaction-Id TransactionDate

Fee Paid (inRs) Agency Name Mode of

Payment

51102353538 IK53747116 21-07-2014 100 State Bank ofIndia

InternetBanking

SSC - Candidate's Application Details (Registration-Id: 51102353538) http://ssconline.nic.in/viewapplication.php

1 of 2 21-07-2014 15:32

Page 2: Application Form of Higher Secondary Exam

Photograph

Specimen signature

SSC - Candidate's Application Details (Registration-Id: 51102353538) http://ssconline.nic.in/viewapplication.php

2 of 2 21-07-2014 15:32