NEET-2017 CHECK LIST

Particulars to be filled in the Online Application Form for NEET-2017

Personal Details

¨Candidate’s Name (Candidate should fill his/her Particulars as per Aaadhar Card)

¨Mother’s Name (Candidate should fill his/her Particulars as per High School Certificate of Board/University)

¨Father’s Name (Candidate should fill his/her Particulars as per High School Certificate of Board/University)

¨Category

¨Date of Birth (Enter the Date, Month and Year of birth as per English Calendar and entry in Aadhaar Card)

¨Gender

¨Nationality

¨State of Eligibility for 15% All India Quota

¨Status of Locomotor Disability of Lower Limbs

¨Disability Details

¨Identification Type

¨Identification No. (Aadhaar Number /Registration No. issued by Facilitation Centre/Passport No./Ration Card No./Bank Account No./Any other valid Govt. ID No.)

¨Medium of Question Paper Language

¨Choice of Examination Centre (1^st Choice / 2^nd Choice / 3^rd Choice)

¨Mobile Number

¨Email ID

¨Security Pin

Previous Year’s AIPMT/NEET Roll No (in case the candidate has appeared in AIPMT/NEET)

¨Have you appeared for AIPMT/NEET in the past (Yes / No.)

¨No of Attempts already availed (1 / 2 / 3)  

¨Details of first attempt (Year__________ Roll No. ________________________)

Academic Details (Class 10^th or Equivalent)

¨Name of School Education Board

¨Name of the School/ College/ Open School Study Centre

¨Address of the School/ College / Open School Study Centre

¨Year of Class 10^th passing

¨Percentage of Marks/Grades obtained in Class 10^th

Academic Details (Class 12^th or Equivalent)

¨School Board of Class XII / Qualifying Exam (Refer Appendix-VII)

¨Name of the School/ College/ Open School Study Centre from where Class 12^th Passed / Appearing

¨Address of the School/ College / Open School Study Centre

¨Place of Study

¨State where Class XII School/ College/ Study Centre is located

¨District where Class XII School/ College/ Study Centre is located

¨Qualifying Examination Code (Refer Para – 3 of Chapter-3)

¨Year of Class XII passing/appearing/Qualifying Exam

¨Percentage of Marks obtained in Class XII/Qualifying Exam (if passed)

¨Roll No of Class XII

Details of Marks of Qualifying Exams
Subjects                       Maximum Marks          Marks Obtained

¨English                                  100                               ?
¨Physics                                  100                               ?
¨Chemistry                              100                               ?
¨Biology/Biotechnology                        100                               ?

Detail of Parents/Guardian’s

¨Father’s/ Guardian’s/ Mother’s Educational Qualifications (Refer Appendix-VI)

¨Father’s/ Guardian’s/ Mother’s Occupation (Refer Appendix-VI)

¨Father’s/ Guardian’s/ Mother’s total Annual Income (Refer Appendix-VI)

Residential Address Details
¨House / Door Number

¨Locality

¨Land Mark

¨Village/Town/City

¨Zip Code

¨State

¨District

¨E-mail Address

¨Mobile Number with Country code

¨Land line with STD Code (Optional)

Miscellaneous

¨Are you the only child of your parents (If yes (no sibling), then write 1 in this column otherwise write 2)

¨State to which the applicant belongs (See Appendix-V)

¨Choice of Exam Centre (Refer Appendix-II)

¨Belonging to Rural/Urban Area

¨Self Declaration (Refer Appendix-III)

Particulars desired to be uploading in the online application:

¨Scanned image of latest Passport size Photograph in JPG format (size of 10 Kb to 100 Kb)

¨Scanned image of Signature in JPG format (size of 3 Kb to 20 Kb)

Mode of Payment: A candidate can pay the fee through

¨Credit Card

¨Debit Card

¨Debit Card + ATM PIN

¨Internet Banking

¨Wallet / Cash Cards