Central Teacher Eligibility Test (CTET JULY 2019)

CENTRAL BOARD OF SECONDARY EDUCATION

Confirmation Page

Application No. 19110492264 -

DO NOT SEND THIS PAGE TO CTET UNIT.
CANDIDATE IS REQUESTED TO RETAIN THE PRINTOUT OF CONFIRMATION PAGE FOR FUTURE REFERENCE.

Personal Details
Candidate's Name SORIFUL ISLAM Date of Birth 24-08-1998
Mother's Name BULBULI KHATUN Category General
Father's Name JAMAL UDDIN Gender Male
Person with Disability (PwD) No Nationality Indian
Language 1 Assamese Language 2 Bengali
Employment Status Not Employed

Apply For
Applying For
Question Paper Medium
1st Choice of Exam Centre
3rd Choice of Exam Centre
Paper-I (Class I-V) Minimum Educational Senior Secondary (or its equivalent) with at least
Qualifications for Classes I to 50% marks and passed or appearing in final year
V of 2- year Diploma in Elementary Education (by
whatever name known)
English Qualifying Exam Diploma in Education
GUWAHATI 2nd Choice of Exam Centre SHILLONG
KOLKATA

Education Details
Qualification Pass Status Course/Stream Name Board/University Name Year Of ResultMode Mark Details Pincode
Passing/
Appearing
Diploma in Appearing Education/Elementry DISTRICT INSTITUTE OF 2019 NA NA 783124
Education Education etc EDUCATION & TRAINING (DIET),
GOALPARA, DUDHNOI, ASSAM-
783124

Contact Details
Address SORIFUL ISLAM Locality MEDORTARI
City/Town/Village FULPUR District DHUBRI
State ASSAM Pin Code 783330
Email Address isl************@gmail.com Mobile Number (+91) 801****680
Land Line No. with STD code or any other Contact No. --

Fee Payment Details

Payment Mode: Online Payment through Billdesk Transaction ID: PSM27242841927
Exam Fee: 700 /- Date of Transaction: 21-02-2019 19:40:50
Fee Submitted On: 21/02/2019
DECLARATION
I hereby solemnly and sincerely affirm that all the particulars stated by me in this Application Form are true and correct and I have verified my eligibility to apply for
CTET JULY 2019. I have not concealed any information. However, if any information furnished herein is found false, wrong, incorrect or inaccurate, I understand
that my candidature for CTET JULY 2019 will be cancelled and lead to cancellation of the test result, forfeiture of certificate and even prosecution. I agree to abide
by the Rules and Regulations governing the Examination as contained in the CTET JULY 2019 Information Bulletin, which I have duly gone through.

Images Uploaded by Candidate

Photograph Signature

List of Document Uploaded

Photograph,Signature

Date of Printing : 15/03/2019 03:05:32 PM