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Subject (M.V.Sc./M.Tech)/M.F.Sc.) Subject Code as ICAR-AIEE (PG)

ICAR Exam. Roll No. ICAR Exam. Application No.

Merit/Score in ICAR-AIEEA (PG)

2. Are you a domicile of Bihar Yes/No

If Yes, Category (UR/SC/ST/EBC/BC/RCG/EWS/OTHERS) 3. Details of Fee

Transaction No. (If paid online) Amount Date Bank Draft No. Name of Bank

4. Name of the candidate (in English)

5. Father's Name (in English)

6. Mother's Name (in English)

7. Date of Birth

(Date) (Month) (Year) 8. Permanent Address

PIN State

9. Address for Correspondence

PIN State 10. Phone/Mobile No.

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Alternate Phone/Mobile No.

11. E-mail ID

12. Gender (M / F) 13. Nationality

14. Particulars of Qualifying Examinations Passed (enter percentage of marks up to two digits after the decimal) / Appearing in

Examination University/

Board

Name of Institution

Marks Obtained

Division Percent - age of marks

Year of Passing

Subjects Total

Marks 10th Standard

12th Standard Bachelor's Degree

DECLARATION

I, hereby declare that the statements made above are true to the best of my knowledge and belief I fully understand that any wrong statement made in this application may result in cancellation of my candidature or termination of my admission at any stage at my cost, risk and responsibility

Signature of the candidate (in Hindi & in English) Date:

Place:

Certificate of the forwarding officer (only for the candidates appearing in the qualifying exam) This is to certify that Sri /Smt. ………is a student of this institution from……… and is appearing in the

………Examination of ……….…..(Name of Program) of this Institute / College.

According to the records of this institution, the information furnished above is correct to the best of my knowledge.

Date:

Place:

Signature of the Head of the Institution Seal of the college last attended/attending FOR OFFICE USE ONLY

Checked

Verified & DD detailed if any

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Subject (Ph.D.) Subject Code as ICAR-AIEE (Ph.D.) ICAR-AIEE (Ph.D.) Exam. Roll No. ICAR-AIEE (Ph.D.) Exam. Application No.

Merit/Score in ICAR-AIEEA (Ph.D.)

2. Are you a domicile of Bihar Yes/No

If Yes, Category (UR/SC/ST/EBC/BC/RCG/EWS/OTHERS) 3. Details of Fee

Transaction No. (If paid online) Amount Date Bank Draft No. Name of Bank

4. Name of the candidate (in English)

5. Father's Name (in English)

6. Mother's Name (in English)

7. Date of Birth

(Date) (Month) (Year) 8. Permanent Address

PIN State

9. Address for Correspondence

PIN State 10. Phone/Mobile No.

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Alternate Phone/Mobile No.

11. E-mail ID 12. Gender (M / F) 13. Nationality

14. Particulars of Qualifying Examinations Passed (enter percentage of marks up to two digits after the decimal) / Appearing in

Examination University/

Board

Name of Institution

Marks Obtained

Division Percent - age of marks

Year of Passing

Subjects Total

Marks 10th Standard

12th Standard Bachelor's Degree

Master's Degree

15. ICAR Roll No.

16. ICAR P.G./Ph.D. Entrance Examination Score

DECLARATION

I, hereby declare that the statements made above are true to the best of my knowledge and belief I fully understand that any wrong statement made in this application may result in cancellation of my candidature or termination of my admission at any stage at my cost, risk and responsibility

Signature of the candidate (in Hindi & in English) Date:

Place:

Certificate of the forwarding officer (only for the candidates appearing in the qualifying exam) This is to certify that Sri /Smt. ………is a student of this institution from……… and is appearing in the

………Examination of ……….…..(Name of Program) of this

Institute / College.

According to the records of this institution, the information furnished above is correct and to the best of my knowledge.

Date:

Place:

Signature of the Head of the Institution Seal of the college last attended/attending FOR OFFICE USE ONLY

Checked

Verified & DD detailed if any

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6. Copy of Score/Merit issued by ICAR-AIEEA (PG) 2020.

7. All the information related to admission can be searched on University Website (www.basu.org.in).

Referensi

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