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SHIROMANI GURDWARA PRABHANDAK COMMITTEE,s

Guru Nanak Khalsa College of Arts, Science & Commerce (Autonomous)
Matunga, Mumbai - 400 019
(Affiliated to University of Mumbai and Recognized by Govt. of Maharashtra)
Accredited by NAAC with 'A' Grade with a CGPA of 3.54 IN HOUSE

ADMISSION FORM (2023 - 2024) PART 1 M.COM.

Registration Form No. : Category : General/Open

PGP1MCOM2232409440

In-house. : Yes

Date : 2023-06-05

1. Personal Information Section

Aadhaar Number : 985206688877 PRN Number :

Surname : KHAN First Name : SHAMAMANAAZ Father's Name : SIRAJ Mother's Name : SAEMA

Date of Birth : 2002-09-25 Place of Birth : LUCKNOW, UTTAR Gender : Female

PRADESH

Nationality : India Blood Group : B+ Mother Tongue : Urdu

Religion : Muslim Caste & Sub-Caste : Marital Status: Single

2. Academic Details
Name of Exam Name of Board/University Name of School/College Passing Date Seat No. CGPA Grade

Graduation University of Mumbai Guru Nanak Khalsa College of 2023-05-12 B- 9

Arts Science and Commerce 2011097

CGPA

SEM I : 9.85 SEM II : 9.40 SEM III : 9.80 SEM IV : 9.55 SEM V : 7.75 SEM VI : 8.75

SEM V Marks (do not count applied component marks) : 392

3. Contact Details

Mobile Number : 7710824850 Email id : shamamanaazkhan@gmail.com

Parent's Mobile Number : 9869978599 Parent's Email id : sirajtahakhan@gmail.com

Address : C/20, 5th floor, Shree Darshan C.H.S,Katrak road, Wadala (w)

State : Maharashtra District : Mumbai Pin Code : 400031

4. Legal Reservation Information

Sikh Minority : No Domicile of State : Maharashtra

Category : General/Open Is Speciallly Abled : ₹ No

Parent's / Guardian's Occupation : Business Annual Income : ₹ 5 - 10 Lac per annum

5. Subject Opted For

Advanced Accountancy

Declaration by Student and Parent/Guardian

We hereby declare that, we have read the rules and eligibility criteria related to admission and the information filled in this form is accurate and
true to the best of our knowledge. We will be responsible for any discrepancy, arising out of the wrong information furnished and signed by us and
we undertake that, in the absence of any document the final admission will not be granted and / or admission will stand cancelled, under such
circumstances we will have no claim against the college.

I seek admission to the aforesaid course and class. I understand that my admission to the said course and class is a provisional admission
subject to confirmation of the same by the college authority. I understood the eligibility criteria for my said admission in the college. I have fulfilled
the eligibility criteria and I am eligible for my said admission. The information given by me in the admission form are true and correct. I am aware
that my admission is liable to be cancelled in case the information furnished by me is found to be incorrect and/or I am found not eligible for the
said admission to the said course for any reason whatsoever at any stage and under such circumstances I will not hold the college responsible
nor will I have any claim or damage against the college.

Place : Mumbai

Date :
Signature of the Parent/Guardian Signature of the Student
(Sign above the line) (Sign above the line)

FOR OFFICE USE ONLY

Checked by - Signature Signature of Prof InCharge / Principal Signature of Cashier

 SHIROMANI GURDWARA PRABHANDAK COMMITTEE,s
Guru Nanak Khalsa College of Arts, Science & Commerce (Autonomous)
Matunga, Mumbai - 400 019
(Affiliated to University of Mumbai and Recognized by Govt. of Maharashtra)
Accredited by NAAC with 'A' Grade with a CGPA of 3.54

DECLARATION BY THE STUDENT

I, KHAN SHAMAMANAAZ of PART 1 M.COM. hereby declare and state as under.

I understand as per University norms I should regularly attend the lectures / practicals / tutorials and that it shall not be the
responsibility of the college to inform me if I default in my attendance, as prescribed by the University / College.

I have carefully gone through the College Prospectus and I affirm that it will be my responsibility to ensure that the internal
assessment task will be accomplished by the prescribed date and the college may proceed to take steps against me if I default in the
same.

I have fully understand the eligibility criteria for admission and I have fulfilled the requisite criteria of qualification for admission.

I understand that my admission in the college will be cancelled and/or term will not be granted and/or I will not be allowed to appear
the semester examination/s if I fail to have the requisite attendance i.e. 75% attendance as prescribed by the university and/or for any
acts prejudicial to the discipline and reputation of the college.

I have read and understood the rules of code of conduct of the college and i will abide by the same.

I am very much aware that ragging in any form is strictly prohibited in the college premises and any violation of the same on my part
will be liable for stringent disciplinary action against me as per the directive of Hon'ble Supreme Court.

Place :

Date : (Signature of the student)

PARENT'S DECLARATION
I have gone through the declaration given by my ward hereinabove and understood the contents therein. I hereby assure that I shall
constantly monitor my ward's academic performance by regular visits to the college.

Place :

Date : (Signature of the Parent / Guardian)