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Application Form

INDIAN COUNCIL OF AGRICULTURAL RESEARCH

ICAR's 18th All India Entrance Examination for Admission to Bachelor Degree Programmes and Award of National Talent Scholarship (AIEEA-UG-2013) in Agriculture and Allied Subject for the

UG

ACADEMIC SESSION 2013-2014

Candidate's Name: Father's Name: Mother's Name: Date of Birth: School Board: State of Domicile: Subject Group: Category: Phone: Nationality: ANURAG SINGH RALAWATA GAJENDRA SINGH VIJAY KANWAR 10/05/1994 Central Board of Secondary Education Rajasthan Biology GEN 01452426128 INDIAN City ENGLISH Private Class X: Class XII: 91.2% 89.2% Signature of Student Stream: Sex: Mobile:

Form No.

131249

Exam City Center: 17 - JAIPUR Agriculture / Biology

Male 9694093608

Place of Residence:
Paper Medium: Type of Institution:

Percentage of total aggregate marks obtained:

Left Thumb Impression Subject Taken in Class XII: Yr. of Passing /appearing class XII: Percentage marks in Class XII in PCB: 1. Physics 2012 86.67% 91% 437/38, RALAWATA HOUSE, PURANI MANDI, AJMER, AJMER, Rajasthan - 305001 Through Online Payment Gateway 2. Chemistry 3. Biology 4. English

Percentage marks in English

Address: Mode of Payment:

Please Write underlined part of the Declaration Given Below In own Handwriting

Declaration: I hereby solemnly affirm that all the particulars stated by me in this Application are true and correct. I have not concealed any information. However, if any information furnished here in is fraudulent, incorrect or untrue, I understand that I am liable to criminal prosecution and I also agree to forego my admission. Further that the selection and admission to the course is liable to be cancelled at any time during the entire degree program. I agree to abide by the rules and regulations governing the examination as contained in the Information Bulletin, which I have duly studied and understood thoroughly.

Signature of the candidate in running hand (NOT IN CAPITAL LETTERS) I have fully read the information furnished by my son / daughter / ward and affirm that it is true and if it is found at any stage that the information is fradulent, I am liable to criminal prosecution. Date: Signature of Father / Mother / Guardian (*If Father and Mother not alive)

Date............................

Place........

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Application Form

ACKNOWLEDGEMENT CARD
Application No. 131249 Dated: ..........................

This is to acknowledge the receipt of your application for 18th All India Entrance Examination for Admission to Under-graduate Degree Programmes and Award of National Talent Scholarships in Agriculture and Allied Subjects other than Veterinary Science for the Academic Session 2013-2014. Please quote your application number, centre code in all correspondence.
City of Exam Centre (Code No.) 17 The Controller of Ex ams (Edn.) Education Division Indian Council of Agricultural Research Room No. 216, Krishi Anusandhan Bhavan-II Pusa, New Delhi 110 012

.
Postage stamp of Rs6.00 (to be pasted by the candidate) AFFIX POSTAGE STAMP OF Rs6.00

Address of the Candidate

To,
ANURAG SINGH RALAWATA 437/38, RALAWATA HOUSE, PURANI MANDI,AJMER AJMER,Rajasthan PIN CODE

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Application Form

OFFICE COPY
ADMIT CARD
(To be submitted along with Application positively) Application Form No.

131249

INDIAN COUNCIL OF AGRICULTURAL RESEARCH Krishi Anusandhan Bhavan-II, Pusa, New Delhi-110012 18TH ALL INDIA ENTRANCE EXAMINATION FOR ADMISSION TO BACHELOR DEGREE PROGRAMMES IN AGRICULTURE AND ALLIED SCIENCE SUBJECTS (OTHER THAN VETERINARY SCIENCES) AND AWARD OF NATIONAL TALENT SCHOLARSHIP FOR THE ACADEMIC SESSION 2013-14
Roll No: STREAM: Agriculture / Biology Optional Subject: .................................. Paste your recent coloured passport size photograph (3.5 x 4.5 cm) To be attested by Principal/Gazetted Officer Name and Address of Candidate ANURAG SINGH RALAWATA 437/38 RALAWATA HOUSE, PURANI MANDI,AJMER AJMER,Rajasthan Date of Exam:20.04.2013 (Saturday) Duration: 10:00 AM to 12:30 PM (2 hours) Reporting Time: 09:30 AM No Entry After: 10:30 AM Cannot Leave Before: 12:30 PM

Name of the City of Examination :

JAIPUR

Venue :

Thumb Impression

Signature of the Candidate

Controller of Exams (Edn)

CANDIDATE COPY
ADMIT CARD
Application Form No.

131249

INDIAN COUNCIL OF AGRICULTURAL RESEARCH Krishi Anusandhan Bhavan-II, Pusa, New Delhi-110012 18TH ALL INDIA ENTRANCE EXAMINATION FOR ADMISSION TO BACHELOR DEGREE PROGRAMMES IN AGRICULTURE AND ALLIED SCIENCE SUBJECTS (OTHER THAN VETERINARY SCIENCES) AND AWARD OF NATIONAL TALENT SCHOLARSHIP FOR THE ACADEMIC SESSION 2013-14
STREAM: Agriculture / Optional Subject: .................................. Biology Name and Address of Candidate Date of Exam:20.04.2013 (Saturday) ANURAG SINGH RALAWATA Duration: 10:00 AM to 12:30 PM (2 hours) 437/38 Reporting Time: 09:30 AM RALAWATA HOUSE, PURANI MANDI,AJMER No Entry After: 10:30 AM AJMER,Rajasthan Cannot Leave Before: 12:30 PM Roll No:

Paste your recent coloured passport size photograph (3.5 x 4.5 cm) To be attested by Principal/Gazetted Officer

Name of the City of Examination :

JAIPUR

Venue :

Thumb Impression

Signature of the Candidate

Controller of Exams (Edn)

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Application Form

Entrance Exam (AIEEA-UG-2013) Fee Deposit Challan (Candidate's Copy)

Entrance Exam (AIEEA-UG-2013) Fee Deposit Challan (ICAR's Copy)

ICAR, Education Division, KAB-II, Pusa, New Delhi Academic Year 2013-13 Syndicate Bank Exam Fee Paid: Under-graduate (UG) Programme: GEN Category Bank Commission: Total Fee Paid: Transaction ID No.: Particulars of Candidate ONLINE Application Form No.:
Name: Father`s Name: Address:

ICAR, Education Division, KAB-II, Pusa, New Delhi Academic Year 2013-13 Syndicate Bank Exam Fee Paid: Under-graduate (UG) Programme: GEN Category Bank Commission: Total Fee Paid: Transaction ID No.: Particulars of Candidate ONLINE Application Form No.:
Name: Father`s Name: Address:

500 0 500 MSPD2900003043

500 0 500 MSPD2900003043

131249
ANURAG SINGH RALAWATA GAJENDRA SINGH 437/38, RALAWATA HOUSE, PURANI MANDI, AJMER, AJMER, Rajasthan

131249
ANURAG SINGH RALAWATA GAJENDRA SINGH 437/38, RALAWATA HOUSE, PURANI MANDI, AJMER, AJMER, Rajasthan

Phone/ Mobile No.:

9694093608

Phone/ Mobile No.:

9694093608

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