1. Name of Candidate 2. Father’s Name 3. Mother’s Name 4. Date of Birth (Must be born on or after 01 Oct, 1998) (DD/MM/YYYY) 5. Nationality 6. Gender (M/F/TG) 7. Category (Tick ) Gen SC ST OBC # 8. HP Category for JUIT, Waknaghat only [Fill Yes/No ] 9. Aadhaar No. of Candidate # Applicable only when passed 10+2 exam from Himachal Pradesh. 10. Details of Qualifying exam (10+2 or equivalent) : 11. Religion (i.e. Hindu/Muslim/Sikh/Jain/Christian/Other) Name of School City/Distt. of School State of School Board Year of Passing 12. Details of JEE Exam - 2019 JEE Application No. JEE (Main) Roll No. 13. Permanent Home address 14. Current Correspondence address (Fill- ‘SAME’ if your correspondence address is same as your permanent address) 15. Contact Details: Mobile No. Land Line No. E-mail ID District State Code (See list on Reverse) PIN Code PLEASE FILL ALL DETAILS IN CAPITAL LETTERS ONLY (ALL FIELDS ARE MANDATORY) Cond...Page2 District State Code (See list on Reverse) PIN Code Application No. JEEbased/2019/WS/…..................……. APPLICATION FORM - 2019 (FOR ADMISSION THROUGH JEE-2019 RANKING) JAYPEE INSTITUTE OF INFORMATION TECHNOLOGY A -10, Sector - 62, Noida - 201309 (U.P.) JAYPEE UNIVERSITY OF INFORMATION TECHNOLOGY Waknaghat, Distt-solan - 173 215 (H.P.) JAYPEE UNIVERSITY OF ENGINEERING & TECHNOLOGY AB Road, Raghogarh, Guna (M.P.) JAYPEE UNIVERSITY ANOOPSHAHR Anoopshahr, Bulandshahr (U.P.) Paste Passport Size Colour Photo