KEMBAR78
Epass Application | PDF | Official Documents | Government
Scribd
Upload
427 views4 pages

Epass Application

This document is a registration form for fresh applicants to an education program for the 2015-2016 year. It requests information such as student details from SSC/CET exams, present college details, contact information, ID uploads, caste and income details, and academic history. Photograph upload is also required.

Uploaded by

Sunil RAYALASEEMA GRAPHICS
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
427 views4 pages

Epass Application

This document is a registration form for fresh applicants to an education program for the 2015-2016 year. It requests information such as student details from SSC/CET exams, present college details, contact information, ID uploads, caste and income details, and academic history. Photograph upload is also required.

Uploaded by

Sunil RAYALASEEMA GRAPHICS
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 4

::ePASS::Fresh Registration 2015- http://apepass.cgg.gov.in/freshregister2016.do?

16:: studentAction=GetForm

Fresh Application Form (2015-16)


Student SSC Details
AP Regular AP Supplementary/Private CBSE ICSE
SSC Pass Type :*
Other Board AP OSS Oriental SSC Direct Degree

1 of 3 11/1/2015 8:11
SSC HallTicket No :* SSC Pass Year :*

Date of Birth :* DD-MM-YYYY

Student CET Details


ils
CET NONCET

CET :* CET Year :*

Enter CET HtNo. :* CET Rank :*

Date of Allotment :* DD-MM-YYYY

Present College Details


College District :* College Mandal :*

University / Board

College : *

Course :* Course Year :*

Mobile
ile No. Veri
erificat
cation
ion
Mobile No. Belongs to : Mobile Number :*

Student Father Mother

Upload Scanned Aadhar Card/UID :

studetn.jpg Yes No Yes No

Enter UID:* ●●●●●●●●●●●● Enter UID:* ●●●●●●●●●●●●


Have
Aadhaar No. Re-Enter UID:* 877306594824 Re-Enter UID:* 754767349311

Upload Scanned Aadhar Card/UID: Upload Scanned Aadhar Card/UID :

atehr.jpg mother.jpg

Have
PAN Card Yes No Yes No Yes No
No:

Have
four wheeler Yes No Yes No Yes No
vehicle:

Caste Details
Religion : Hindu

Caste : EBC(LISTED) Subcaste : KAPU

Ration Car
Card Details
Ration Card No.
Type
(Not mandatory):

Caste Certi
ertifficate for SC/ST/BC and Nativity Certif
tificat
cate for EBC/OC Minor
nority
ity /OC PHC
Mee Seva No. : * CGC011506743381

Mee Seva No. : * CGC011506743381 Approved Date : * 08/10/2015


KASIREDDY CHANDRA
Applicant Name : * KASIREDDY KALPANA Father Name : *
SEKHAR REDDY
ANANTHAPURAMU
District/State : * Mandal : * DHARMAVARAM
/Andhra
T.Narayana Moorthy
MRO Name : * Caste : * HINDU/KAPU (OC)
(FAC)

Income Certificat
cate Details
Mee Seva No. : * IC011505444008

Mee Seva No. : * IC011505444008 Approved Date : * 25/07/2015


K CHANDRA SEKHAR
Applicant Name : * K KALPANA Father Name : *
REDDY
District/State : * Ananthapuramu /Andhra Mandal : * Dharmavaram
T.Narayana Moorthy
MRO Name : * Total Income : * 60000.00
(FAC)
Academic
Class District Mandal Village School/College Name
Year

-- Select -- -- Select -- --Select--

--Select--

--Select--

--Select--

--Select--

--Select--

--Select--

Student Phot
hotograph
Image of your Passport Photograph : * No file selected.

@d esigned and developed by Centre for Good Governance.

You might also like