Application Form for AIEEE 2012

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Application Form For AIEEE 2012

Exam Related Details

Courses Applying for : Mode of Examination : Question Paper Medium :

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Personal Details

Candidate's Name : Mother's Name : Father's Name : State of Eligibility : Category : Whether Blind Candidate ? : Person With Disability : Date of Birth : Gender: In case of girl candidate, Are you the only child of your parents? : Nationality : Place of Residence :
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(dd/mm/yyyy)

Academic Details ( List of Qualifying Examinations)

School Board of Class XII / Equivalent : Type of Institution of Class XII / Equivalent :

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http://aieee.nic.in/aieee2012/aieee/online/ApplicationForm.aspx

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Application Form for AIEEE 2012

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Mode of Preperation : Year of Passing or Appearing Class XII / Equivalent : Percentage of Marks obtained in Class X : Percentage of Marks obtained in Class XII / Equivalent :

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(% In Round Figure) (% If Passed,In Round Figure)

Contact Details

Enter Your Email Address : Enter Your Mobile No. :

Guardian Details # Qualification Occupation

Father's/Guardian's : Mother's :

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Details of Examination Passed or Likely to be Passed

Name of the Examination Passed / appearing : Board / University : Name & Address of the School / College from where passed / appearing : Year of passing / appearing : Roll Number (if alloted) :

Security Pin

Enter Security Pin (Shown in green colour) : Security Pin :

Disclaimer: This site is designed and hosted by NIC and the contents are provided by CBSE. For any further inf Designed and Developed by
Education Informatics Division National Informatics Centre

http://aieee.nic.in/aieee2012/aieee/online/ApplicationForm.aspx

12/3/2011

Application Form for AIEEE 2012

Page 3 of 3

Ministry of Communications & Information Technology Government of India New Delhi

http://aieee.nic.in/aieee2012/aieee/online/ApplicationForm.aspx

12/3/2011