ACADEMIC YEAR 2022-2023 Student Id : 3688021

VIDYAVARDHINI’S A.V.COLLEGE OF ARTS, K.M.

COLLEGE OF COMMERCE AND E.S.A. COLLEGE OF
SCIENCE
NAVGHAR ROAD, BESIDE VASAI ROAD RAILWAY STATION,
VASAI (W), DIST. PALGHAR(MS) 401202.

COLLEGE UNIVERSITY OF MUMBAI

CODE : 361 Application for Admission to BACHELOR OF COMMERCE (BCOM) - 5
Academic Year - 2022-2023
Application Number - 313

Applicant's Personal Details PRN Number :

Surname First name Father's name

Name of the Student SAVE PRIT VIKAS

Mother's Name AMRITA

Student Full Name(MARATHI) ससवव पपत पवकसस

Date of Birth 26/12/2002 Place Of Birth PALGHAR

Birth State MAHARASHTRA Birth District PALGHAR

Marital Status UNMARRIED Blood Group B+

Religion HINDU Gender MALE

Nationality INDIAN Aadhaar card Number 515324073074

Mother Tongue MARATHI Employment Status Unemployed

Anti Ragging Number Sub Caste OPEN

NCC/NSS NO Is Orphan NO
Caste Category OPEN Student has internet YES
connectivity
Handicap(Divyang) NA

Student has a Desktop/ NO Medium ENGLISH MEDIUM

Laptop/ Smart phone

Contact Details

Student Phone Parent's Mobile Number

Student Mobile Number 9359783495

Student's Email Id save.prit26@gmail.com

Address of Correspondence

Address B/403, VARTAK HEIGHTS, PHOOLPADA ROAD,VIRAR (EAST)

State Maharashtra District Palghar

Taluka VASAI City/Town/Village PALGHAR

Pincode 401305

Permanent/Native Address

Address B/403, VARTAK HEIGHTS, PHOOLPADA ROAD,VIRAR (EAST)

State Maharashtra District Palghar

Taluka VASAI City/Town/Village PALGHAR

Pincode 401305

Father's/Husband's Full VIKAS

Name

Father's/Husband's Occupatio GOVT. JOB Gross Annual Income 1,000,000

Father's/Husband's Mobile 9892726082
Father's/Husband's Office
Address

Exam Details

Sr.No. Course Name SGPA Result

1 BACHELOR OF COMMERCE (BCOM) - 1 9.70 PASS
2 BACHELOR OF COMMERCE (BCOM) - 2 9.40 PASS
3 BACHELOR OF COMMERCE (BCOM) - 3 9.70 PASS
4 BACHELOR OF COMMERCE (BCOM) - 4 9.60 PASS

Preferenace : 1 Group Name : COMPUTER SYSTEM

AUDITING PAPER VIII COST ACCOUNTING
AUDITING PAPER VII FINANCIAL ACCOUNTING-V
COMMERCE – V (MARKETING)
BUSINESS ECONOMICS – V
DIRECT AND INDIRECT TAXATION – I (DIRECT TAX)
COMPUTER SYSTEM AND APPLICATIONS PAPER – I

Course Name : BACHELOR OF COMMERCE (BCOM) - 6

Subject Name Subject Type

Preference Number : 1 Group Name : COMPUTER SYSTEMS AND APPLICATION

FINANCIAL ACCOUNTING AND AUDITING IX-FINANCIAL ACCOUNTING COMPULSORY

FINANCIAL ACCOUNTING AND AUDITING X-COST ACCOUNTING COMPULSORY

BUSINESS ECONOMICS –VI COMPULSORY

COMMERCE –VI COMPULSORY

DIRECT AND INDIRECT TAXATION –II COMPULSORY

COMPUTER SYSTEMS AND APPLICATION -II OPTIONAL

 Sr. No. Attached Documents and Certificates Original/Attested True Copy Yes/No

1 10/12 LEAVING CERTIFICATE 1 Attested copies YES

2 AADHAR CARD 1 Attested copies YES

3 SEMESTER I -MARKSHEET 1 Attested copies YES

4 SEMESTER II -MARKSHEET 1 Attested copies YES

5 SEMESTER III -MARKSHEET 1 Attested copies YES

6 SEMESTER IV -MARKSHEET 1 Attested copies YES

Declaration by Student

I hereby declare that, I have read the rules related to admission and the information filled in by me in this form is accurate
and true to the best of my knowledge. I will be responsible for any discrepancy, arising out of the form signed by me and I undertake
that, in absence of any document the final admission will not be granted and / or admission will stand cancel.

Date : 11/06/2022 Signature of the Student

Declaration by Guardian / Parent

I have permitted my son / daughter / ward to join your college.The information supplied by him / her is correct to the best of
my knowledge. I have acquainted myself with the rules and fees, dues to my son / daughter / ward and see that he / she observes.

Date : 11/06/2022 Signature of the Guardian/Parent

 For College / Institute Use Only

Designation Remarks / Particulars /Recommendations Signature and Date

Admission Clerk

Admission Committee

Accountant / cashier

Registrar/Office
superintendent

REMARK OF THE ADMISSION COMMITTEE

May be admitted to Class ____________________________________________________ Section ________________

May be Rejected __________________________________________________________________________________
Last date of payment of fees _________________________________________________________________________
Admission may be cancelled if the fees are not paid by this date.

Principal Signature of Admission Committee

Other Details
 VIDYAVARDHINI’S
A.V.COLLEGE OF ARTS, K.M. COLLEGE OF COMMERCE AND E.S.A. COLLEGE OF
NAVGHAR ROAD, BESIDE VASAI ROAD RAILWAY STATION, VASAI (W), DIST. PALGHAR(MS)
401202.

ANTI RAGGING UNDERTAKINGS (AFFIDAVITS) BY STUDENTS AND PARENTS / GUARDIANS

TO BE FILLED BY A STUDENT (Online & submit printout along with admission form) www.amanmovement.org
<http://www.amanmovement.org>
Fields marker with* are compulsory.
v If you do not have an Email address please create on before you fill in this form.
v If your mother or father or guardian does not have a phone or a mobile phone or email then please give the
numbers/email of their friends or relations or neighbors.
v If you do not have a mobile number, then please give the mobile number of your friend in the college.
After filling this form successfully you will receive the Student’s Anti Ragging Undertaking (Affidavit) and the Parents
Anti Ragging Undertaking (Affidavit) in you Email. Please print both the Undertakings (Affidavit). Sign them yourself,
request your parents to read the details and request them to sign their undertaking (Affidavit) and then present both
at your college at the time of registration each year.
Students Personal Details:

Name :
SAVE PRIT VIKAS AMRITA

(Surname) (Students Name) (Father Name) (Mother Name)

Gender : MALE Nationality : INDIAN

Student’s Mob. No. : 9359783495 Incase of Emergency contact Mob. No. : 9892726082

Student’s Email ID: Landline No. :

Permanent Address :
B/403, VARTAK HEIGHTS, PHOOLPADA ROAD,VIRAR (EAST)

Parent/Guardian Details:

Parent/Guardian Name:

Parent/Guardian Occupation : Parent/Guardian Mob. No. :

Parent/Guardian Address :

State in which College is : Maharashtra

Is it a professional or general College : General
Name of the College : Vidyavardhini’s A.V.College of Arts, K.M. College of Commerce & E.S.A.
College of Science, Vasai Road, (W). Dist. Palghar.
Name of Affiliating University : Mumbai University
Is it deemed University : No
Principal Name : Dr. Arvind W. Ubale College Phone No. 0250-2332017
College Email ID :
Nearest Police Station Name & Address : Manikpur Police Station, Ambadi Road,Vasai Road (w)

Course Details :
Under Graduate of Post Graduate : Undergraduate
Note : Online Registration of this form is compulsory for all the students.
 GROUP INSURANCE FORM ATTACHED WITH ADMISSION FORM

VIDYAVARDHINI’S
A.V.COLLEGE OF ARTS, K.M. COLLEGE OF COMMERCE AND E.S.A. COLLEGE OF
NAVGHAR ROAD, BESIDE VASAI ROAD RAILWAY STATION, VASAI (W), DIST. PALGHAR(MS) 401202.

“YUVA RAKSHA”
(Group Insurance Scheme for Students)
STUDENT’S REGISTRATION FORM
(Copy to be submitted alongwith the Admission Form)

1) Name of Insured (Student) : SAVE PRIT VIKAS

2) Class : BACHELOR OF COMMERCE (BCOM) - 5

3) Residential Address : B/403, VARTAK HEIGHTS, PHOOLPADA ROAD,VIRAR (EAST)

4) Mobile No./Contact No. : 9359783495

5) Blood Group : B+

6) Name of Guardian :

7) Guardian Mobile No :

8) Amount of Premium Paid in : Rs. 0.00/-

Note : Subject to be changed as per the Insurance is circular, claim will be start form the actual
payment of premium to insurance company not from the date of Admission.

Parent’s/Guardian Signature Student’s Signature

FOR OFFICE USE ONLY:-

Received from student (Name SAVE PRIT VIKAS of BACHELOR OF COMMERCE (BCOM) - 5 course)

Premium Rs. 0.00/- against the Receipt No. _________________________ dated __________________

Head
Institute/Department/College Seal/Stamp with Signature
(College to preserve the slip along with Admission form)