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Application Form

The document contains the application details of Chandra Lakshmi Vardhan, an Indian male applicant born on April 7, 2008, applying for an undergraduate BTech program in Engineering. The application includes personal, contact, and address information, along with payment details and a declaration confirming the accuracy of the provided information. The applicant acknowledges the admissions process and agrees to the terms and conditions outlined in the declaration.

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zayinahk
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7 views1 page

Application Form

The document contains the application details of Chandra Lakshmi Vardhan, an Indian male applicant born on April 7, 2008, applying for an undergraduate BTech program in Engineering. The application includes personal, contact, and address information, along with payment details and a declaration confirming the accuracy of the provided information. The applicant acknowledges the admissions process and agrees to the terms and conditions outlined in the declaration.

Uploaded by

zayinahk
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

APPLICANT DETAILS

Name CHANDRA LAKSHMI VARDHAN Application Number 126219434

Email ID kuthadilakshmi101975@[Link] Mobile Number +919177303267

Gender Male Date of Birth 07/04/2008 Nationality Indian

CATEGORY DETAILS

Category General Sub Category General

PROGRAM DETAILS

Program Level Undergraduation - UG Stream Engineering

Course BTech

Tentative Test Telangana - Tentative Test Telangana - Tentative Test Karnataka -


Location 1 Hyderabad Location 2 Warangal Location 3 Bengaluru

PARENT OR GUARDIAN DETAILS FOR COMMUNICATION

Full Name kuthadi lakshmi

Email kuthadilakshmi101975101975@[Link] Mobile Number 919885117659

ADDRESS DETAILS

Address Type Address 1 Address 2 City State Country Pincode

Correspondence Address Road No2 Jawahar Colony Chandanagar Plot No21 Hyderabad Telangana India 500050

Permanent Address Road No2 Jawahar Colony Chandanagar Plot No21 Hyderabad Telangana India 500050

PAYMENT DETAILS

Transaction Id 114384283729 Date 23/03/2026 Amount INR 2000.00

DECLARATION

• I hereby confirm that the above-mentioned details are correct. I declare that all the
particulars stated in this application form are true to the best of my knowledge and belief. I
have read and understood all provisions of the admissions process and agree to abide by them. I
also affirm that I fulfill the eligibility requirements for the program(s) applied. I
understand that I can only apply once for each group. In case I apply more than once, only
one of my applications will be accepted, and the application and entrance test fees remitted
will not be refunded.
• If it is found at a later stage, during active verification, that I have provided false, incorrect
or untrue information w.r.t educational qualifications, marks, nationality, etc., or submitted an
eligibility document from an unrecognized board or university, my admission or degree will
be canceled without notice, with forfeiture of all fees paid.
• Jurisdiction for disputes, if any, shall be at the Udupi Court, Karnataka, India only.

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