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FIRST YEAR DEGREE ADMISSION FYBMS
FORM 2021-22
Date : 13, Aug 2021 Form No. :7465
Category MKCL No : 279224
Applying Category : General Student Type : Outsider
Personal Information
Student Name As Per HSC
: SAURABH VIKRAM PAREKH
Marksheet
Mother Name
Last Name First Name Middle Name
VANDANA
PAREKH SAURABH VIKRAM
PAREKH
Gender : Male Date of Birth : 23, May 2004
Domicile
:MAHARASHTRA Religion : JAIN
(State)
Caste : Sub-Caste :
Nationality : Indian Marital Status : Other
Permanent Address Address for Correspondence
C 602, Persiana, Casa Rio, Palava C 602, Persiana, Casa Rio,
Thane-421204 Palava
Maharashtra Thane-421204
Maharashtra
Mother Tongue : Hindi Aadhar No : 951002174702
Mobile No. : 9137396398 Email Id : saurabhparekh2305@gmail.com
Blood Group : A+ Place of Birth : RAIPUR, CHATTISGARH, INDIA
Is Foreign
: no
Student?
ACADEMIC PERFORMANCE
Passed HSC With (STREAM) : Science Marks Obtained In Maths :
Passed HSC With ? : First Attempt Passed with Exemption : No
Exam Board/State School/College Seat/Roll Month of Marks Marks
Percentage
Name Name Name No Passing Obtained Out Of
Pawar Public School
ICSE ICSE 9825312 May, 2019 534 600 89
Dombivali
Lodha World School
12th ISC 9825312 Jul, 2021 416 500 83.2
Palava
COURSE APPLIED FOR
FYBMS
INFORMATION TO BE FILLED BY PARENTS
TOTAL FAMILY INCOME : 5 lakh to 8 lakh p.a TOTAL FAMILY MEMBERS : 3
Father Mother
Name Vikram Parekh Vandana Parekh
Qualification
Occupation
Name of Organisation
Designation
Office / Residential Address
Office / Residential Tel. No.
Gross Annual Income
Mobile No. 8898801234
Tel. No. (Resi.)
Email ID
Aadhar No
UNIVERSITY ORDINANCE ON ATTENDANCE
Ordinance 0.6086
Students joining this college are required by the University Circular no. UG /502 dated 16th Oct .1999, to read and
accept the provision of University Ordinances No, 0.6068 and 0.125 given below: 0.6068 Every bonafide learner shall
ordinarily be allowed to keep terms for the given semester in the program of his/her enrolment, only if he /she fulfills at
least seventy five percent (75%) of the attendance taken as an average of the total number of lectures, Practicals,
Tutorials, Further, it is mandatory for every learner to have minimum 50% attendance for each course (paper) and
average attendance has to be 75%, 0.125 To keep a term at the college or recognized institution, an undergraduate
must complete to the satisfaction of the Principal or the Head of the institution, the course of study at the College or
Institution prescribed for such term for the class to which such undergraduate then belongs i.e satisfactory performance
at the various examinations conducted during the year.
Prohibition of Ragging Act/Ordinance
UGC Regulations on Curbing the Menace of Ragging in Higher Educational Institutions 2009.
"Ragging in all its forms is totally banned in this institution including in its departments, constituent units, all its
premises (academic, residential, sport, kiosk, canteen and the like) whether located within the campus or outside and
in all means of transportation of students whether public or private, The Institution shall take strict action including but
not limited to criminal proceeding and/or cancellation of admission against those found guilty of ragging and/or of
abetting ragging and the burden of proof shall lie on the perpetrator of alleged ragging and not on the victim. An
offense of Ragging may be charged either on a written complaint by the affected or on independent finding of the Anti -
Ragging Squad. The institution is bound by the UGC Regulations on Curbing the Menace of Ragging in Higher
Educational Institutions 2009."
The order of The Honourable Supreme Court of India regarding punishment for ragging is as follows:
If any incident of ragging comes to the notice of the authority, the concerned student shall be given liberty to explain
and if his explanation is not found satisfactory, the authority would expel him from the institution."
UNDERTAKING BY STUDENT
1. I, have carefully read the UGC Regulations on Curbing the Menace of Ragging in Higher Educational Institutions,
2009, (hereinafter called the Regulations) and fully understood the provisions contained in the said Regulations.
2. I am aware as to what constitutes ragging.
3. I am fully aware of the penal and administrative action that is liable to be taken against me in case I am found
guilty of abetting ragging, actively or passively, or being part of a conspiracy to promote ragging.
4. I hereby solemnly aver and undertake that I will not indulge in any behavior or act that may be constituted as
ragging under the Regulations. I will not participate in or abet or propagate through any act of commission or
omission that may be constituted as ragging under the Regulations.
5. I hereby affirm that, if found guilty of ragging, I am liable for punishment according to the Regulations, without
prejudice to any other criminal action that may be taken against me under any penal law or any law for the time
being in force. I hereby declare that I have not been expelled or debarred from admission in any institution in the
country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging; and further
affirm that, in case the declaration is found to be untrue, I am aware that my admission is liable to be canceled.
I have read the rules and conditions for subject/Course choice in the college prospectus and am also aware of
the university eligibility Criteria.
I, further declare that my admission may be cancelled, at any stage, if I am found ineligible and/or the
information provided by me is found to be incorrect.
Date ______________________________
______________________________
13, Aug 2021 Student's Signature Parents/Guardian's Signature
Declaration of the Guardian
I, the undersigned, Mr./Mrs. Vikram Parekh
Parent/ Guardian of SAURABH VIKRAM PAREKH
I have Permitted my ward who is my ................................. to join the college.
I have carefully read the rules and regulations set forth in the college prospectus; and I am pleased to give my
assurance that my ward will always strictly abide by them.
I fully endorse his/her application and the solemn declaration he/she has made.
13, Aug 2021
______________________________ ______________________________
Date Parents/Guardian's Signature
University of Mumbai
DECLARATION /UNDERTAKING FROM THE STUDENT
I, Mr. /Ms PAREKH SAURABH VIKRAM VANDANA PAREKH
Mobile No: 9137396398
Email Address: saurabhparekh2305@gmail.com here by declare that, information submitted in admission form is correct. I am
confirming my admission for course FYBMS at college JOHN WILSON EDUCATION SOCIETY'S WILSON COLLEGE for
academic year 2020-21. My registration no of Mumbai University digital portal is Pre Enrollment No. : 279224.
1. I will not confirm my admission to any other college.
2. I will submit my all original documents to college.
3. I am aware that if information in my admission form found wrong or even I submitted my original documents in another
college my admission will treat as canceled.
College admission Form No. 7465
13, Aug 2021
______________________________ ______________________________
Date Signature of Student
DECLARATION BY PARENT/ GUARDIAN
I Vikram Parekh, (Mother / Father / Guardian)
hereby fully endorse the above undertaking/declaration given by my child/ward. And I will endeavour to induce my child/ward
to do his/her best to observe the above stated undertaking in words and spirit.
13, Aug 2021
______________________________ ______________________________
Date Signature of Mother / Father / Guardian
