HARISH KUMAR SONWANI Kushabhau Thakre Patrakarita Avam Jansanchar Vishwavidyalaya (M.sc1se.)

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KUSHABHAU THAKRE PATRAKARITA AVAM JANSANCHAR VISHWAVIDYALAYA

KATHADIH, POST OFFICE-SUNDER NAGAR, RAIPUR (C.G.) 492013


PH : 0771 2779202,15 Fax : 0771 2779210

ACADEMIC SESSION : 2021-2022


Application Form for Admission to Various Courses in the University/College

1)Course applied for : M. Sc. (Electronic Media)


Kushabhau Thakre Patrakarita Avam
2)SOS/College :
Jansachar Vishwavidyalaya
3)Full Name : HARISH KUMAR SONWANI
4)Gender : MALE

5)Category : SC
Signature Of Applicant
6)Sub Category : NONE

10-05-1998,VILL. JOTPUR TH. LORMI DIST.


7)Date & Birth of Place :
MUNGELI
8)Nationality : INDIAN
9)Email : [email protected]
10)Contact : 7879753739
11)Mother Name : DEEPA BAI
12)Fath./Husband's Name : ASHWANI KUMAR
DINDYAL GRIH NIRMAD MANDAL WARD
13)Address : NO. 45 SHIRISHTI COLONY
RAJNANDGAON 491441
Name Of Exam Board/University Year Marks / Division / Grade Result Subject Studied
HIGH SCHOOL CG BOARD RAIPUR 2015 207/600=34.5% PASS ALL COM.
HIGHER SECONDARY CG BOARD RAIPUR 2017 190/500=38% PASS ARTS
UG K.T.U RAIPUR 2021 1955/3000=65.16% PASS B.A JMC
Note : A COPY OF THIS FORM ALONG WITH THE FEE RECIEPT, PHOTOSTAT/ SCANNED COPIES OF SCHOOL / DEGREE
CERTIFICATES, AND CERTIFICATE
INDICATING DATE OF BIRTH, BE SUBMITTED AT THE TIME OF COUNSELING/ ADMISSION.
Declaration : I declare that I shall submit myself to the disciplinary jurisdiction of the authorities of the University
which may be

vested with the powers to exercise discipline under the Act, the Statutes, the Ordinances and the
Rules that may be framed by the
University/ Board from time to time.

DETAIL OF APPLICATION FEES


Mode Of Payment:Online Order Reference No.:KTUJM2101638
Amount: 150.00 Transaction Id :110348982441
Date Of Payment:02/12/2021 17:32:05-Success Bank Ref No.:173156 Payment Status: Success/Success

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