Aieee 2009 - Sample Online Form

AIEEE 2009 - OnLine Form

1 of 1

http://aieee.nic.in/aieee2009/exam09/online/onlineform.aspx

APPLICATION FORM FOR AIEEE 2009 #Marked fields are Optional and rest are Mandatory Candidate's Name as given in Class X Certificate Mother's Name Father's Name as given in Class X Certificate Choice of the exam center (First Choice is Mandatory) 1 st Choice: ----Select----

# 3 Choice: ----Select---# th 4 Choice: ----Select---#

2ndChoice: ----Select---rd

----Select-------Select-------Select------Select-------Select----

State Code of Eligibility (From Where +2 Passed/Appeared) Gender In case of girl candidate, Are you the only child of your parents? Nationality Question Paper Medium Date of Birth (As per Class X Certificate)(in DD/MM/YYYY Format)

----Select-------Select-------Select-------Select-------Select-------Select-------Select-------Select----

Place of Residence Category Whether Physically Handicapped ? School Board of Class XII Type of Institution of Class XII Mode of Preperation Courses Applying for Year of Passing/Appearing Class XII

% %

Percentage of Class X Marks (In Round Figure) Percentage of Class XII Marks (If Passed,In Round Figure)

Educational Qualification#

Occupation#

Annual Income#

Father's/Guardian's

----Select----

----Select----

----Select----

Mother's

----Select----

----Select----

----Select----

Please Enter Your Email Address# Telephone No. with STD Code# (write STD Code first followed by phone no.)

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) Enter Security Pin (Shown In Green Color)

Security Pin Submit Form

Reset Your Data

12/6/2008 10:46 AM