Andhra Pradesh Residential Educational Institutions Society (Regd.

),
Hyderabad
Application for APRJC Common Entrance Test -2015

Personal Details
1 Reference Id : 4100033613
2 Surname : JANA
3 Candidate Name : J MANI CHARAN
4 Father Name : RANGAMURTHY
5 Mother Name : RADHAMMA
6 Date of birth : 12/7/2000
7 Gender : Male
8 Address : HNO 1-2968
SMT COLONY

Mandal : Yemmiganur
District : KURNOOL
Pincode: 518360
9 e-Mail : shankar.ravi2855@gmail.com
10 Mobile : 9949550046
11 Reservation Category : BC-B
12 Medium of Study in Class X : ENGLISH
13 Category(General/Minority) : General
14 Group/Course Opted : MPC
15 Mention District by Study/Nativity : KURNOOL
16 Reservation under Sports : No
17 Reservation under CAP(Childern of Armed No
Personnel) :
18 Are you a Physically Handicapped(PH) No
Person :
Qualification Details
19 Board : BOARD OF SECONDARY EDUCATION,A.P
20 SSC Hallticket Number : 1520120261
21 Examination Center : KURNOOL
22.Payment Details
Fee Amount Journal Number Payment Date
150 /- CSBH3747387903 15/04/2015
I hereby declare that
I read the information bulletin of APRJC CET 2015 and found myself fully eligible to appear for the entrance test
as per the criteria mentioned in the bulletin.
I am appearing for Class X(2015) Public examinations as a fresh candidate(First attempt, not compartmental) and the
particulars furnished above are true to the best of my knowledge and belief.
Sd/-
J MANI CHARAN