7/24/23, 10:27 PM about:blank

For Office Use

Batch: Scrutiny Payment: Online/DD PI

Only Serial:

GURU NANAK KHALSA COLLEGE OF ARTS,SCIENCE AND COMMERCE (57)

Application No :
University of Mumbai 2450440
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
Academic Year: 2023-2024
Regular
APPLICATION FORM

Course Applied for : B.Sc. (I.T.) (Autonomous)(with Credits) - Regular - CBCS - PRN:2020016401499643
T.Y.B.Sc. (I.T.) (Autonomous) Sem V (-)

Application Date : 22/07/2023 Payment Category : 13

1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed on MHATRE SARVESH SUNIL SANCHITA
Mark sheet : [*This name will appear on all University records/documents]
Father's/Husband's Name : SUNIL Mother's Name : SANCHITA

Marital Status : UnMarried Mother Tongue :

Place Of Birth : KOPARKHAIRANE Gender : Male Date of Birth (DD/MM/YYYY) : 26/11/2001
Blood Group : Religion : Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Thane Tehsil : Thane City/Town/Village :
Available
Address (House
Nl-5/3/7 SECTOR-1A Nerul (East) Pin Code : 400706
no,street/area/suburb etc.) :
Contact details
Mobile Number 919819799259 Email ID: sarveshmhatre88@gmail.com
2.Legal Reservation Information
Category Type :
Category : OBC
Reserved
Is Guardian from EBC (Economic Backward
Is Specially Abled? No
Class)? No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem V
BSCIT001 - PAPER I BSCIT002 - PAPER II
BSCIT003 - PAPER III BSCIT004 - PAPER IV
Sem VI

BSCIT005 - PAPER V BSCIT006 - PAPER VI

BSCIT007 - PAPER VII BSCIT008 - PAPER VIII

Medium of Instruction : English

4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 350000
5.Educational Details
Month and Exam
Name of Name of Board/University and State Name of Certificate Mark
Year of Seat Out of CGPA %
Examination of University School/College No. Obtained
Passing No.
MAHARASHTRA STATE BOARD OF
Std 10th SECONDARY AND HIGHER March 2018 -- -- 441.00 500.00 -- - -- 88.20
SECONDARY EDUCATION,
MAHARASHTRA STATE BOARD OF
Std 12th 12Th February
SECONDARY AND HIGHER -- -- 470.00 650.00 -- - -- 72.31
(Science) 2020
SECONDARY EDUCATION,
Your Last Qualifying Exam:

about:blank 1/2
7/24/23, 10:27 PM about:blank

7.Other Information
Would you like to apply for Hostel accommodation required NA
DECLARATION
I hereby declare that all the information furnished by me in this application form is true, complete and correct to the best of my knowledge and belief. I do
understand that I need to obtain and produce all the required documents. I admit to having understood what constitutes ragging and sexual harassment. I
have read the guidelines related to the same. I hereby affirm that if found guilty of ragging or sexual harassment I am liable for punishment according to
the university regulations.

Place : Date :
( Signature of the Candidate )
Document printed on Mon Jul 24 2023 22:27:41 GMT+0530 (India Standard Time)

about:blank 2/2