Nerist Form

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3/22/2021

NORTH EASTERN REGIONAL INSTITUTE OF SCIENCE AND TECHNOLOGY


DEEMED TO BE UNIVERSITY U/S 3 OF UGC ACT 1956
(UNDER THE MINISTRY OF EDUCATION, GOVT. OF INDIA)
NIRJULI (ITANAGAR), ARUNACHAL PRADESH
PIN - 791 109
Application ID:
NE0754192277 Application for Admission to
Payment ID: B.Sc in Forestry ( 10+2 with PCB)
NEE6058822a1fd14732
Rs: 600 (Mode: ONLINE) NEE-II : 2021
Dt: 2021-03-22 17:12:29

01. Name of the Candidate: NADA NANCY


02 Father's Name : Mr. NADA APA
Mother's Name: Mrs. NADA OKA
03. Permanent address
Building/H.No: E-131, near govt. sec school pachin, City: pachin colony naharlagun, PO: naharlagun, Dist: papum pare, State: Arunachal
Pradesh , Pin: 791110.
Mobile No: 9436223527
04. Category : ST
05. Address for Communication
Building/H.No: E-131, near govt. sec school pachin, City: pachin colony naharlagun, PO: naharlagun, Dist: papum pare, State: Arunachal
Pradesh , Pin: 791110.
Mobile No: 9436223527, Email Id: [email protected]
06. Date of birth: 28/ May /2003
Marital Status: Single
Gender: Female
Religion: Christian
07. Educational Qualifications :
Name of Examination Name of Board/ University Year of Division/Class School Name/College % of marks CGPA
Passing
Class X/ Madhyamic / Central Board of Secondary
2018 1 siang model school 70
Secondary Education, Delhi
10+2/ Higher Central Board of Secondary
2020 1 govt.hr secondary school itanagar 64.8
Secondary (PCB) Education, Delhi
08. Employed: No
09. State of Domicile : Arunachal Pradesh
10. Reservation Code : 1109 - APST PRC holders of Arunachal Pradesh
11. NERIST Student : No
12. Physically Challenged: No
13. Exam Centre Preferances : 1) Itanagar. 2) Ziro.
I certify that the above statements are true.
I Undertake:
a) The information given above is true and complete to the best of my
knowledge and belief, and if any of it is to be incorrect at any stage, my
admission shall be liable to be cancelled. Date: 22-03-2021 Signature of the candidate
b) To abide by the provisions of the Act, Statutes, Ordinances, Regulations
and Rules of the Institute failing which the Institute may take appropriate
action against me.
N.B.All notices regarding admission will be available in the Institute website (https://nerist.ac.in).

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