2/11/13Application 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........ icarexam.net/ICAR_Exam/PrintOutForm.php 1/4 216..... centre code in all correspondence. ANURAG SINGH RALAWATA 437/38. Please quote your application number. RALAWATA HOUSE.. PURANI MANDI.. New Delhi 110 012 ..php 2/4 ...2/11/13 Application Form ACKNOWLEDGEMENT CARD Application No..... Krishi Anusandhan Bhavan-II Pusa. 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.. City of Exam Centre (Code No.) Education Division Indian Council of Agricultural Research Room No.. 131249 Dated: ..Rajasthan PIN CODE icarexam.00 Address of the Candidate To.net/ICAR_Exam/PrintOutForm...) 17 The Controller of Ex ams (Edn......AJMER AJMER.00 (to be pasted by the candidate) AFFIX POSTAGE STAMP OF Rs6... Postage stamp of Rs6. 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: ..net/ICAR_Exam/PrintOutForm....2013 (Saturday) ANURAG SINGH RALAWATA Duration: 10:00 AM to 12:30 PM (2½ hours) 437/38 Reporting Time: 09:30 AM RALAWATA HOUSE......04..Rajasthan Cannot Leave Before: 12:30 PM Roll No: Paste your recent coloured passport size photograph (3...5 x 4.2013 (Saturday) Duration: 10:00 AM to 12:30 PM (2½ 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.php 3/4 ...... 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: ........... Biology Name and Address of Candidate Date of Exam:20....AJMER No Entry After: 10:30 AM AJMER..... Paste your recent coloured passport size photograph (3..Rajasthan Date of Exam:20...... PURANI MANDI.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) icarexam. Pusa.. 131249 INDIAN COUNCIL OF AGRICULTURAL RESEARCH Krishi Anusandhan Bhavan-II.. PURANI MANDI.... 131249 INDIAN COUNCIL OF AGRICULTURAL RESEARCH Krishi Anusandhan Bhavan-II.......5 cm) To be attested by Principal/Gazetted Officer Name and Address of Candidate ANURAG SINGH RALAWATA 437/38 RALAWATA HOUSE...2/11/13 Application Form OFFICE COPY ADMIT CARD (To be submitted along with Application positively) Application Form No. Pusa...AJMER AJMER...04...... RALAWATA HOUSE. AJMER. Pusa. AJMER. PURANI MANDI.: Name: Father`s Name: Address: ICAR.: Name: Father`s Name: Address: 500 0 500 MSPD2900003043 500 0 500 MSPD2900003043 131249 ANURAG SINGH RALAWATA GAJENDRA SINGH 437/38. KAB-II. Education Division.php 4/4 .: Particulars of Candidate ONLINE Application Form No. RALAWATA HOUSE. Rajasthan 131249 ANURAG SINGH RALAWATA GAJENDRA SINGH 437/38. KAB-II. AJMER.: 9694093608 Phone/ Mobile No. Education Division. Rajasthan Phone/ Mobile No. PURANI MANDI. 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. Pusa.net/ICAR_Exam/PrintOutForm.2/11/13 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.: 9694093608 icarexam. AJMER. 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.