JEE APPLICATION FORM
(Question marked # are optional)
Exam Related Details
Applying For : a. JEE (Main) Paper – 1 (B.E/B.Tech.) Only b. JEE (Main) Paper – 2 (B.Arch/B. Planning) Only c. JEE (Main) Paper – 1 and Paper – 2 Both
Choice of Online Exam Centre : CHENNAI (TAMIL NADU)
Mode of Examination : a. Pen and Paper b. Computer Based
Question Paper Medium : a. Hindi b. English
Personal Details
Candidate’s Name :
Father’s Name :
Mother’s Name :
State Of Eligibility : TAMIL NADU
Category : a. General b. SC c. ST d. OBC – NCL (Central List)
Person with Disability (PwD) : a. Yes b. No
Date of Birth : (dd/mm/yy) :
Gender : a. Male b. Female
In case of girl candidate, Are you only child of your parents? : a. Yes b. No
Nationality : INDIAN
Place of Residence : a. Rural b. Urban
Aadhaar Number (UIDAI) # :
Academic Details
Year of Passing Class 10th or its Equivalent : a. 2012 b. 2013
School Board of Class 12th/Qualifying Exam : a. TAMIL NADU BOARD OF HIGHER SECONDARY EDUCATION
b. CENTRAL BOARD OF SECONDARY EDUCATION
Name of the Qualifying Examination passed/Appearing : THE FINAL EXAMINATION OF THE 10+2 SYSTEM, CONDUCTED BY ANY RECOGNIZED CENTRAL/ STATE BOARD, SUCH AS CENTRAL BOARD OF SECONDARY EDUCATION, NEW DELHI; COUNCIL FOR THE INDIAN SCHOOL CERTIFICATE EXAMINATIONS, NEW DELHI; ETC.
Place of class 12th / Qualifying Exam Schooling : a. City b. Town c. Village
Year of Passing or Appearing Class 12th/Qualifying Exam : a. 2015 b. 2014 c. 2013
Type of Institution of Class 12th/Qualifying Exam : a. Government b. Private
Percentage of Marks in Class 12th/Qualifying Exam :
Roll Number of Class 12th/Qualifying Exam :
Appearing for Improvement of Class 12th/Qualifying Exam : a. Yes b. No
Mode of Preparation : a. Self-study b. Individual tuition c. Coaching d. Correspondence courses e. Others
Name of the School / College