[ Computer Copy ]

Chaudhary Charan Singh University, Meerut

Application Form for Admission through Entrance Test in University Campus and Aided / Affiliated Colleges : 2021-22

1. Course Applied For : M.Ed.

2. Name of the Candidate : ANJALI BHATI
3. Father`s Name : KRISHAN PAL SINGH
Form No:22211410
4. Mother`s Name : SUNITA
5. Date of Birth : 10/09/1998 6. Gender : Female
7. Original Resident of : U.P. 8. Kashmiri : No
9. Category : OBC [104]
10. Belongs to EWS : No
11. State from where Graduated : Uttar Pradesh
12. Do you have Domicile Cert. of U.P. State : Yes 13. Marital Status : Unmarried
14. Permanent Address : 72/14 ANAND VIHAR ROADWAYS BUS STAND ,
BULANDSHAHR, BULANDSHAHR, Pin : 203001
15. Present Address : 72/14 ANAND VIHAR ROADWAYS BUS STAND ,
BULANDSHAHR, BULANDSHAHR, Pin : 203001
16. Mobile No. (Candidate) : 8532955228
Mobile No. (Parent) : 9837702892 Signature of Candidate
Mobile No. (Friend) : 7830669772
17. Email ID : ANJALIBHATI235@GMAIL.COM
Your College Preferences
1. Bulandshahar
2.
3.

18. Description of Examination:

Name of Year Name of the School/College Name Subject Offered Mrks Max. Per.(%) Acad.
Examination Board/University obt. Mrks Scores
High School 2014 CBSE , DELHI Nirmala Convent school, Hindi, Science, Maths, 285 500 57.00 3
Bulandshahr Social Science, English
Intermediate 2016 CBSE, DELHI Renaissance School English, Accountancy, 366 500 73.20 5
Bulandshahr Economics, Business
Studies
Graduation 2019 CCS UNIVERSITY, I.P. College 1st Campus Corporate Accounting, 1251 2100 59.57 7
MEERUT Bulandshahr Money and financial
Manageme
B.Ed/L.T./B.T. 2021 CCS UNIVERSITY, M.S. Institute Bulandshahr Environmental Education,
(Theory) MEERUT Community Engagement
B.Ed/L.T./B.T. 2021 CCS UNIVERSITY, M.S. Institute Bulandshahr Social Science, Commerce
(Practical) MEERUT
B.Ed/L.T./B.T. (Total) 2021 CCS UNIVERSITY, M.S. Institute Bulandshahr Creating an inclusive,
MEERUT Assessment for learning
Post Graduation
Total Score 15
19. If Qualifying Exam Result is Awaited and Student of CCS University Roll No. : 2008760003 Enrolment No. : 16082274
20. Whether you were punished for any offence/unfair means committed by you in the previously attended or the present institution, then fill-up the
following information Year : Class : Result :
21. Dependent of Freedom Fighter : No
22. Dependent of Ex-serviceman categories : No
23. If in services whether part-time or full time give details : No
24. Reservation Claimed : Yes
25. Annual Income of the Parents : 540000

Page 1/4
 [ Computer Copy ]
Chaudhary Charan Singh University, Meerut
Application Form for Admission through Entrance Test in University Campus and Aided / Affiliated Colleges : 2021-22

Course Applied For Name of the Candidate From No.

M.Ed. (01) ANJALI BHATI 22211410

26. Checklist (Attached Documents)

Marksheet of High School : Yes Marksheet of Intermediate : Yes Marksheet of Graduation : Yes
Marksheet of Post Graduation : No Residence/Domicile Certificate : No Handicap Certificate : No
Caste Certificate :Yes Mark Sheet of B.Ed/L.T./ B.T. : No
Any other certificate 1. No 2. No
Detail of Application Fee
Total Fees : Rs. 700/- Payment Status : PAID Transaction No. : 50000030539 Date : 10/08/2021

Important Note :
Note 1: Current GOs accepted by executive council of C.C.S. University, Meerut will be applicable.

Note 2: All Candidates whose result is awaited must submit the complete result to office of DSW,CCS University, Meerut within one week of
declaration of their results or before starting of Admission process in colleges and campus, whichever is earlier. If the result of qualifying course is not
received in the office of DSW in time, the candidature will not be entertained for admission

Note 3: The declaration of Entrance Exam result does not ensure position in merit or admission. Tentative merit will be displayed coursewise after
receiving completed result of qualifying course up to the certain date declared by the university.

Declaration
I ANJALI BHATI(22211410) hereby declare that I have read the eligibility conditions given in Information Brochure very carefully and I undertake
the responsibility of fulfilling eligibility conditions. The entries in the form are correct to the best of my knowledge and belief. If any entry is found to be
wrong or false, my admission may be cancelled at any time. I will pay all dues in accordance with the University rules and regulations and also abide
by the rules of conduct, behavior and studies

Undertaking
I, ANJALI BHATI D/o Shri. KRISHAN PAL SINGH , undertake not to involve directly or indirectly, in any kind of ragging.

Instruction for Candidates

Printed hard copies of the downloaded copy of the filled Application Form with documents must be submitted at the time of counselling. No Form will
be accepted by hand or through courier or registered post in any case.

Date:___________________

Place:___________________ (Full Signature of the Applicant)

Page 2/4
 [ University Copy ]
Chaudhary Charan Singh University, Meerut
Application Form for Admission through Entrance Test in University Campus and Aided / Affiliated Colleges : 2021-22

1. Course Applied For : M.Ed.

2. Name of the Candidate : ANJALI BHATI
3. Father`s Name : KRISHAN PAL SINGH For Office Use Only Form No:22211410
4. Mother`s Name : SUNITA
5. Date of Birth : 10/09/1998 6. Gender : Female
7. Original Resident of : U.P. 8. Kashmiri : No 1. Obtained Marks in
9. Category : OBC [104] Entrance Test = .................
10. Belongs to EWS : No
11. State from where Graduated : Uttar Pradesh 2. Academic Scores = ...........
12. Do you have Domicile Cert. of U.P. State : Yes 13. Marital Status : Unmarried
14. Permanent Address : 72/14 ANAND VIHAR ROADWAYS BUS STAND ,
Total Scores = ....................
BULANDSHAHR, BULANDSHAHR, Pin : 203001
15. Present Address : 72/14 ANAND VIHAR ROADWAYS BUS STAND ,
BULANDSHAHR, BULANDSHAHR, Pin : 203001
16. Mobile No. (Candidate) : 8532955228 Signature of the teacher

Mobile No. (Parent) : 9837702892 Signature of Candidate

Mobile No. (Friend) : 7830669772
17. Email ID : ANJALIBHATI235@GMAIL.COM
Your College Preferences
1. Bulandshahar
2.
3.

18. Description of Examination:

Name of Year Name of the School/College Name Subject Offered Mrks Max. Per.(%) Acad.
Examination Board/University obt. Mrks Scores
High School 2014 CBSE , DELHI Nirmala Convent school, Hindi, Science, Maths, 285 500 57.00 3
Bulandshahr Social Science, English
Intermediate 2016 CBSE, DELHI Renaissance School English, Accountancy, 366 500 73.20 5
Bulandshahr Economics, Business
Studies
Graduation 2019 CCS UNIVERSITY, I.P. College 1st Campus Corporate Accounting, 1251 2100 59.57 7
MEERUT Bulandshahr Money and financial
Manageme
B.Ed/L.T./B.T. 2021 CCS UNIVERSITY, M.S. Institute Bulandshahr Environmental Education,
(Theory) MEERUT Community Engagement
B.Ed/L.T./B.T. 2021 CCS UNIVERSITY, M.S. Institute Bulandshahr Social Science, Commerce
(Practical) MEERUT
B.Ed/L.T./B.T. (Total) 2021 CCS UNIVERSITY, M.S. Institute Bulandshahr Creating an inclusive,
MEERUT Assessment for learning
Post Graduation
Total Score 15
19. If Qualifying Exam Result is Awaited and Student of CCS University Roll No. : 2008760003 Enrolment No. : 16082274
20. Whether you were punished for any offence/unfair means committed by you in the previously attended or the present institution, then fill-up the
following information Year : Class : Result :
21. Dependent of Freedom Fighter : No
22. Dependent of Ex-serviceman categories : No
23. If in services whether part-time or full time give details : No
24. Reservation Claimed : Yes
25. Annual Income of the Parents : 540000

Page 3/4
 [ University Copy ]
Chaudhary Charan Singh University, Meerut
Application Form for Admission through Entrance Test in University Campus and Aided / Affiliated Colleges : 2021-22

Course Applied For Name of the Candidate From No.

M.Ed. (01) ANJALI BHATI 22211410

26. Checklist (Attached Documents)

Marksheet of High School : Yes Marksheet of Intermediate : Yes Marksheet of Graduation : Yes
Marksheet of Post Graduation : No Residence/Domicile Certificate : No Handicap Certificate : No
Caste Certificate :Yes Mark Sheet of B.Ed/L.T./ B.T. : No
Any other certificate 1. No 2. No
Detail of Application Fee
Total Fees : Rs. 700/- Payment Status : PAID Transaction No. : 50000030539 Date : 10/08/2021

Important Note :
Note 1: Current GOs accepted by executive council of C.C.S. University, Meerut will be applicable.

Note 2: All Candidates whose result is awaited must submit the complete result to office of DSW,CCS University, Meerut within one week of
declaration of their results or before starting of Admission process in colleges and campus, whichever is earlier. If the result of qualifying course is not
received in the office of DSW in time, the candidature will not be entertained for admission

Note 3: The declaration of Entrance Exam result does not ensure position in merit or admission. Tentative merit will be displayed coursewise after
receiving completed result of qualifying course up to the certain date declared by the university.

Declaration
I ANJALI BHATI(22211410) hereby declare that I have read the eligibility conditions given in Information Brochure very carefully and I undertake
the responsibility of fulfilling eligibility conditions. The entries in the form are correct to the best of my knowledge and belief. If any entry is found to be
wrong or false, my admission may be cancelled at any time. I will pay all dues in accordance with the University rules and regulations and also abide
by the rules of conduct, behavior and studies

Undertaking
I, ANJALI BHATI D/o Shri. KRISHAN PAL SINGH , undertake not to involve directly or indirectly, in any kind of ragging.

Instruction for Candidates

Printed hard copies of the downloaded copy of the filled Application Form with documents must be submitted at the time of counselling. No Form will
be accepted by hand or through courier or registered post in any case.

Date:___________________

Place:___________________ (Full Signature of the Applicant)

Page 4/4