National Institute of Electronics and Information Technology
Ministry of Electronics and Information Technology, Government of India
O LEVEL ONLINE EXAMINATION FORM -  JANUARY, 2024
Application Number Application Date & Time For Office Use Only 
EOIT0124017846 14-Nov-2023 09:29:10 PM
  Demand Note No.  8816693
  Demand Note Date   14-Nov-2023
  Batch No.  
1. Applicant's Personal Details / आवेदक का व्यक्तिगत विवरण
Applicant's Full Name / आवेदक का पूरा नाम Mr.Aman Kumar Prajapati
Father's/Guardian's Name / पिता/अभिभावक का नाम Mr. Pawan Kumar Prajapati
Mother's Name / माता का नाम Mrs. Anita Devi
Date of Birth / जन्म दिनांक (dd/mm/yyyy) 03-May-2005
2. Registration Details / पंजीयन का विवरण
Registration No. / पंजीकरण संख्या 1557902
Course Name / कोर्स का नाम O LEVEL
Candidate Type / उम्मीदवार का प्रकार Direct Candidate
3. Contact Details / संपर्क विवरण
Phone with STD code / दूरभाष एस टी डी कोड सहित
Mobile Number / मोबाइल नंबर 8354921008
Email Address / ईमेल पता govindakumar621@yahoo.in
4. Correspondence Address / पत्राचार का पता
Address / पता TIWARI KA PURA , VINDHYACHAL KEWTAN, MIRZAPUR
MIRZAPUR
District:- Mirzapur,
State:- Uttar Pradesh,  Pin:- 231307
5. Exam Details / परीक्षा का विवरण
Exam Name / परीक्षा का नाम January, 2024
Exam Centre First Choice / परीक्षा केंद्र पहला विकल्प UPMIR (Mirzapur)
Exam Centre Second Choice / परीक्षा केंद्र दूसरा विकल्प UPVNS (Varanasi)
Improvement/इम्प्रूवमेंट No
Modules Appearing / मॉड्यूल देने 01.  M1-R5.1   INFORMATION TECHNOLOGY TOOLS AND NETWORK BASICS
02.  M2-R5.1   Web Designing & Publishing
Practicals Appearing / प्रैक्टिकल देने 01.  PR1   PRACTICAL1
02.  PR2   PRACTICAL2
6. Fee Details / शुल्क विवरण
No. of Modules X Fee/Module / मॉड्यूल की संख्या X शुल्क/मॉड्यूल (0 x 750.00 + 2 x 1000.00) 2000.00
No. of Practicals X Fee/Practical / प्रैक्टिकल की संख्या X शुल्क/प्रैक्टिकल (0 x 500.00) 0.00
Exam Form Processing Fees / परीक्षा फार्म का प्रसंस्करण शुल्क 100.00
Late Fees(if applicable) / विलंब शुल्क (यदि लागू हो) 0.00 (Not Applicable)
Total Fees / कुल शुल्क Two Thousand One Hundred Rupees Only 2100.00
8. Payment Detail
Applying This Exam As Direct Candidate
Application Examination Fee will be Deposited by Candidate
Payment Mode: ONLINE
Transaction no. of payment receipt प्राप्त ट्रांजेक्शन संख्या दर्ज करें ZHD51534908177 Transaction Date 14-Nov-2023 09:30
 Note * : Please don't send this form without making payment./कृपया इस फार्म को भुगतान के बिना नहीं भेजें
 Note *: Please pay examination fee through available payment options and after making payment submit this form for institute verification to the institute mentioned above in the form. /कृपया भुगतान के लिए उपलब्ध विकल्पों में से किसी एक का चयन करके परीक्षा शुल्क का भुगतान कर ऊपर वर्णित संस्थान को सत्यापन के लिए परीक्षा फार्म प्रस्तुत करें |
 Note *: Last date of payment of examination fee / परीक्षा शुल्क का भुगतान की अंतिम तारीख: 23-Nov-2023
7. Declaration / घोषणा
I Aman Kumar Prajapati S/oPawan Kumar Prajapati registered as a Direct Candidate hereby declare that, all the particular stated in the application, are true to the best of my knowledge and belief. I hereby certify that I have applied the aforesaid checks before submitting the Online Examination Form. I have read and understood all the instructions available on the site. I agree to abide by the rules and regulations of the NIELIT and also to the decision of the Examination Authority, on any issue related to my admission to the Examination. I have noted that the Examination Authority has the right to withhold my result ever after appearing in the Examination in addition to any other action as may be deemed fit in the event of any of the statements made above being found incorrect or my candidature being found ineligible at a later date. I have specially gone through the eligibility criteria laid down by NIELIT for appearing in different examinations and I confirm that I fullfill the eligibility for the Theory & Practical modules, I have applied for.
Left hand thumb impression / बाएं हाथ के अंगूठे का निशान   Signature of Applicant/ हस्ताक्षर