JEE Main 2014 (Demo) Online Application Form Application Form For JEE(Main) JEE(Main)-2014 Exam Related Details ► Applying For:
JEE(Main) Paper – 1 (B.E/B.Tech.) Only JEE(Main) Paper – 1 (B.Arch/B.Planning) B.Arch/B.Planning) Only JEE(Main) Paper-11 and Paper – 2 Both
Mode of Examination:
PEN AND PAPER BASED EXAMINATION COMPUTER BASED EXAMINATION
Question Paper Medium:
HINDI ENGLISH
Personal Details ► Candidate’s Name: Mother’s Name: Father’s Name: State of Eligibility:
NOTE: (1) State code of eligibility means the Code of the State from where the candidates has passed Class 12th/equivalent qualifying examination by virtue of which he/she becomes eligible to appear in the JEE(Main) for admission to B.E/B.Tech and B.Arch/B. Planning Courses of the institutions/Colleges of the States/UT. (2) If a candidate has passed Class 12th/equivalent qualifying examination from one state but appeared for improvement ment from another state, his/her state code of eligibility will be from where he/she has originally passed Class 12th/equivalent qualifying examination and not the state from where he/she has appeared for improvement (3) Indian nationals passing the equiva equivalent lent qualifying examination from an institution abroad, the State of Eligibility will be determined on the basis of permanent address in India as given in the Passport of the candidate. However the candidates who have passed/appearing in the qualifying examination exa from _____________________________________________________________________________________ Helpline Numbers: 099582 96397, 09777837437 (24 Hrs) Email:
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Nepal/Bhutan the state code of eligibility is given in the list.
Category :
General SC ST OBC-NCL(CENTRAL NCL(CENTRAL LIST) NOTE: State list OBC Candidates who are not in OBC OBC-NCL NCL central list must choose General.
Person With Disability (PWD): Yes No Date of Birth: NOTE: Only those candidates whose date of birth alls on or after October 01, 1989 are eligible. However, in the case of Scheduled Caste (SC), Scheduled Tribe (ST) and Persons with Disabilities (PWD) candidates, upper age limit is relaxed by 5 years, i.e. SC, ST and PWD candidates who were born on or after October 01, 1984 are eligible. Date of birth as recorded in the Secondary Education Board/University certificatee will only be considered.
Gender: Male Female In case of girl candidate, Are you only child of your parents?:
Yes
_____________________________________________________________________________________ Helpline Numbers: 099582 96397, 09777837437 (24 Hrs) Email:
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No
Nationality:
INDIAN OCI PIO FOREIGH (OTHER THAN OCI, PIO)
NOTE : Foreign candidates are not eligible for admission to NITs, IIITs, CFIs through JEE(Main) Channel
Place of Residence:
RURAL URBAN
Aadhaar Number (UIDAI) [Optional]: #
Academic Details ► Year of Passing Class 10th or its Equivalent: School Board of Class 12th/Qualifying Exam: Code of the Qualifying Examination passed/appearing: NOTE: 01 The final examination of the 10 +2 system, conducted by an recognized central/state Board, such as Central Board of Secondary Education, New Delhi; Council for the Indian School Certificate Examinations, New Delhi; etc. 02 Intermediate or two-year Pre-University University examination conducted by a recognized Board/University 03 Final examination of the two-year year course of the joint Servic Services es Wing of the National Defence Academy 04 Senior Secondary School Examination conducted by the National Institute of Open Schooling with a minimum of five subjects. 05 Any Public School/Board/University examination in India or in any foreign country recognized recog as equivalent to the 10+2 system by the Association of India Universities (AIU). 06 H.S.C vocational examination, [Only for Admission to IITs] 07 A Diploma recognized by AICTE or a state board of technical education of at least 3 year duration. [Only for admission to IITs] 08 General Certificate te Education (GCE) examination (London/Cambridge/Sri lanka at the Advanced (A) ( _____________________________________________________________________________________ Helpline Numbers: 099582 96397, 09777837437 (24 Hrs) Email:
[email protected] web:
WWW.ENTRANCEINDIA.COM
(JEE Main, JEE Advanced, AIPMT, JIPMER, AIIMS, BITSAT, VITEEE, Medical PG, ACET & More)
level. [Only Only for Admission to IITs]. 09 High School Certificate Examination of the Cambridge University or International Baccalaureate Diploma of the International Baccalaureate Office, Geneva. [Only for Admission to IITs]. Place of class 12th/Qualifying Exam Schooling: CITY TOWN VILLAGE Year of Passing or Appearing Class 12th/Qualifying Exam: 2014 2013 2012 NOTE: Only those candidates who have passed their Class 12th Exam or any other qualifying examination in 2011 or 2012; or those who are appearing in their Class 12th Exam or any other qualifying examination in 2014 are eligible to appear in JEE(Main) JEE(Main)-2014. 2014. Candidates who passed Class 12th/Qualifying examination in 2010 or before as well as those who will appear in such examination in 2014 or later are not eligible to appear in JEE(Main) JEE(Main)-2014. 2014. Candidates who appeared in class 12th/other Qualifying Examinations in 2010, did not pass in 2010, but passed in 2011 are als also o not eligible to appear in JEE(Main)2014. Type of Institution of Class 12th/Qualifying Exam: GOVERNMENT PRIVATE Percentage of Marks in Class 12th/Qualifying Exam: Roll Number of Class 12th/Qualifying Exam: Appearing for Improvement Class 12th/Qualifying: Yes No Mode of Preparation: SELF STUDY INDIVIDUAL TUTION COACHING CORRESPONDENCE COURSES OTHERS Name of the School/College from where passed/appearing: Address of the School/College from where Passed/appearing: _____________________________________________________________________________________ Helpline Numbers: 099582 96397, 09777837437 (24 Hrs) Email:
[email protected] web:
WWW.ENTRANCEINDIA.COM
(JEE Main, JEE Advanced, AIPMT, JIPMER, AIIMS, BITSAT, VITEEE, Medical PG, ACET & More)
Mailing Address details ► Address: Locality: City/Town/Village: District: State: Pin Code: Email Address: Mobile Number: Land Line No. with STD code or any other Contact No: #
Guardians Details ► Qualification Father’s/Guardian’s: #
Occupation
Annual Income
`
Mother’s: # Note:►
ILLITERATE MATRICULATE GARDUATE POST GRADUATE OTHERS
AGRICULTURE BUSINESS MEDICAL ENGINEERING LAW PRACTICE GOVERNMENT SERVICE PUBLIC SECTOR SERVICE PRIVATE SERVICE TEACHING/REASEARCH ARCHITECTURE PHARMACY SELF EMPLOYMENT OTHERS
UPTO 100000 RS.100001-200000 RS.100001 RS.200001-300000 RS.200001 RS.300001-400000 RS.300001 RS.400001-500000 RS.400001 Rs.500001-600000 Rs.500001 RS.600001-700000 RS.600001 RS.700001-800000 RS.700001 Rs.800001 AND ABOVE
_____________________________________________________________________________________ Helpline Numbers: 099582 96397, 09777837437 (24 Hrs) Email:
[email protected] web:
WWW.ENTRANCEINDIA.COM
(JEE Main, JEE Advanced, AIPMT, JIPMER, AIIMS, BITSAT, VITEEE, Medical PG, ACET & More)
(INCLUDING HOUSE WIFE)
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WHICH IS THE WEBSITE YOU RARELY VISIT? WHAT PLANT YOU LIKE OR DISLIKE? WHAT IS YOUR NEIGHBOR PET NAME? WHAT IS REGISTRATION NUMBER OF YOUR FIRST VEHICLE? WHICH BOOK DO YOU LIKE?
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Security Answer:
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_____________________________________________________________________________________ Helpline Numbers: 099582 96397, 09777837437 (24 Hrs) Email:
[email protected] web:
WWW.ENTRANCEINDIA.COM
(JEE Main, JEE Advanced, AIPMT, JIPMER, AIIMS, BITSAT, VITEEE, Medical PG, ACET & More)
