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Shailendra Education Societys Arts, Science and Commerce College (460)

Application No :
University of Mumbai
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
2259025
Academic Year: 2022-2023 Regular
APPLICATION FORM

Course Applied for : B.Sc. (I.T.)(with Credits) - Regular - Rev16 - T.Y. B.Sc. (I.T.) Sem V [1S00255] PRN:2020016401006616
(42300003)

Application Date : 03/08/2022 Payment Category : 28

1.Personal Information
Candidate's Name(Regional) :
DUBE SHUBHAM ANIL
Candidate's Name as printed on
[*This name will appear on all University
Mark sheet :
records/documents]
Father's/Husband's Name : ANIL Mother's Name : SEEMA
Marital Status : UnMarried Mother Tongue :
Place Of Birth : Varanasi Gender : Male Date of Birth (DD/MM/YYYY) : 06/01/2002
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
no,street/area/suburb 602, Prathamesh Tower Maschachapada Road, Sai Krupa Complex Kashigoan Pin Code : 401107
etc.) :
Contact details
Mobile
918850134921 Email ID: sadubey01062002@gmail.com
Number
2.Legal Reservation Information
Category Type :
Category : GEN
Open
Is Guardian from EBC (Economic
Is Specially Abled? No
Backward Class)? No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem V [1S00255]
53701 - Software Project Management 53702 - Internet of Things
53703 - Advanced Web Programming USIT5P1 - Project Dissertation
USIT5P2 - Internet of Things Practical USIT5P3 - Advanced Web Programming Practical
53705 - Linux System Administration USIT5P5 - Linux Administration Practical
53706 - Enterprise Java USIT5P6 - Enterprise Java Practical
Sem VI [1S00256]

88701 - Software Quality Assurance 88702 - Security in Computing

88703 - Business Intelligence USIT6P1 - Project Implementation
USIT6P2 - Security in Computing Practical USIT6P3 - Business Intelligence Practical
USIT6P6 - Advanced Mobile Programming 88705 - Enterprise Networking
USIT6P5 - Enterprise Networking Practical 88706 - IT Service Management
Medium of Instruction : English
4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 300000
5.Educational Details
Month and Exam
Name of Name of Board/University and Name of Certificate Mark Out
Year of Seat CGPA %
Examination State of University School/College No. Obtained of
Passing No.
MAHARASHTRA STATE BOARD
March
Std 10th OF SECONDARY AND HIGHER -- -- 342.00 500.00 -- - -- 68.40
2018
SECONDARY EDUCATION,
MAHARASHTRA STATE BOARD
Std 12th 12Th February
OF SECONDARY AND HIGHER -- -- 327.00 650.00 -- - -- 50.31
(Science) 2020
SECONDARY EDUCATION,
Your Last Qualifying Exam:
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 Wed Aug 03 2022 08:27:52 GMT+0530 (India Standard Time)