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FILLED IN ONLINE APPLICATION FORM FOR COMPUTER BASED TEST (CBT)
1. Stream Applied For # : Engineering (E)
2. (a) Qualifying Examination # : TGBIE INTERMEDIATE (REGULAR)
(b) Qualifying Exam Latest Hall Ticket Number # : 2558284851 Preserve the below REGISTRATION
(c) Year of Appearing/Passed the Qualifying Exam : 2025 NUMBER
for all future correspondence.
(d) Medium of Instruction at Qualifying Exam : English
REGISTRATION NO. :
(e) Place of Study - Intermediate or Equivalent : Rural
A151438378CD
(f) Bridge Course Hall Ticket No. (if any) : N.A
3. Medium of Test : English & Telugu
4. (a) Candidate's Name # : SAMA NEHA
(b) Father's Name : SAMA SURENDAR REDDY
(c) Mother's Name : SAMA SRAVANTHI
(d) Date of Birth (as per SSC or Equivalent) # : 19/06/2007
(e) Gender : Female
5. (a) Category # : OC
(b) Do you belong to Economically Weaker : YES (EWS022400539278)
Section (EWS)? #
6. Special Reservation Category # : NA
7. Physically Challenged(PH) # : NO
(i) a) Blindness and low vision; : NO
(ii) b) Deaf and hard of hearing; : NO
(iii) c) Locomotor disability including cerebral palsy, : NO
leprosy cured, dwarfism, acid attack victims and
muscular dystrophy;
(iV) d) Autism, intellectual disability, specific : NO
learning disability and mental illness;
(V) e) Multiple disabilities from amongst persons
under clauses (a) to (d) including deaf-blindness : NO
in the posts identified for each disabilities;
8. (a) Non-Minority / Minority : Non-Minority
(b) Minority Category : N.A
9. Annual Income of the Parents (Rs.) : 1 Lakh and above – below 2 Lakhs
10. (a) Study Details I to XII
Class-I RANGA REDDY Class-II RANGA REDDY
Class-III RANGA REDDY Class-1V RANGA REDDY
Class-V RANGA REDDY Class-V1 RANGA REDDY
Class-VII RANGA REDDY Class-VIII RANGA REDDY
Class-IX RANGA REDDY Class-X RANGA REDDY
Inter-I RANGA REDDY Inter-II RANGA REDDY
(b) 10+2 / Diploma Studied In : OTHER PRIVATE COLLEGES
(c) Place of Study - SSC or Equivalent : Rural
(d) SSC Hall Ticket Number, Month & Year of : 20224407 , May - 2023
Passing
11. Area of Reservation : Local ( OU Area i.e, Telangana State)
12. (a) Address for Correspondence : 2-28, KAPPAPAHAD,
IBRAHIMPATNAM, RANGA REDDY,
TELANGANA, 501506
(b) Candidate's / Student's Mobile Number # : 9000256582 (c) E-Mail Id # : samasravanthireddy1908@[Link]
(d) Aadhaar Card No. (Optional) : 419344140112
13. Test Zones
Preference - 1 Preference - 2 Preference - 3
Hyderabad (III) Hyderabad (I) Hyderabad (II)
14. (a) Fee particulars - Payment through : ONLINE (b) Amount (in Rs.) 900.00 (c) Payment Reference Id : TGP15157983145
# - These Fields CANNOT be edited by candidate, but written request can be made to the CONVENER, TG EAPCET-2025 or email to tgeapcethelpdesk2025@[Link] , Remaining fields
can be edited by the candidate during the permitted period. For any details contact at +91-7416923578 and +91-7416908215
Declaration : I have carefully gone through the detailed notification and instruction booklet. I shall abide by the rules and regulations mentioned in the notification for
appearing at the TG EAPCET - 2025 examination. Further, I assure that, I will not involve in any malpractice or illegal activities in the TG EAPCET - 2025
examination. I understand that if any information submitted by me is proved to be false, then I am liable for criminal prosecution.
Submitted Date : 22/03/2025 3:36 PM
Print Date : 22/03/2025 03:36 PM
LEFT HAND THUMB Impression of the candidate to be done well in
advance(atleast a day before the examination)
SIGNATURE OF THE CANDIDATE Left Hand Thumb Impression
in the presence of the Invigilator and submit to
Invigilator on the day of Examination
Affix a recent colour photograph
(3.5 cmX3.5 cm) (Well in advance
BEFORE EXAMINATION)
Note : 1) ALL the candidates have to submit this form in the Examination Hall to the Invigilator.
2) Candidates are not allowed into the Examination Hall even if they are LATE BY A MINUTE.
3) This is computer generated sheet and does not require the signature of the CONVENER, TG EAPCET-2025
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