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NIFT Admission - 2016Application Form

*Application No. 469762

*Programme applied for B.DES.-DESIGN

Test Centre Details

* Date of Written Test 14thFebruary 2016 (Sunday)

*Test Cen tre Cit y Name Delh i

Personal Particulars

*Name TANMAY SINGH

*Mother's Name SEEMA SINGH *Father's Name SP SINGH

*Date of Birth 02-Aug-1998 *Category GEN

*Gender Male *Nationality INDIAN

* State Domicile(State in which candidate has completed his /her class 12th Qualifying Examination): Other

*Are you Physically Handicapped? NO

*Address for Communication HOUSE NO.261, ASHOKA ENCLAVE MAINE, SECTOR 35

*City FARIDABAD *State Haryana-121003

Email-ID tanmay.singh1998@gmail.com

Contact No. - *Mobile No. 9599005839

Qualifying Examination

*Qualification: 10+2 *Status of 10+2/Equivalent

Examination Appeared/Appearing

Mode of Payment: --> Credit/Debit Card

*Transaction Reference No. 239998 *Payment Date 1/9/2016 1:00:11 PM

*Receipt No/PG Ref.No.

053156148527330/148527330

*Amount 1500

I hereby agree to the NIFT 2016 admission guidelines and affirm that the statement made and information furnished by me in the Online ApplicationForm is true and correct and it will be my responsibility to establish the same as and when required. In case of incomplete or untrue information my

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application form will be rejected.

You are NOT required to send Application Form/any documents/receipt to NIFT.

Place

Signature of ApplicantDate

(Please Print the form for Further Reference)

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