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Vivekanand Education Societys College of Arts, Science and Commerce (345)

Application No :
University of Mumbai
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
2817555
Academic Year: 2023-2024 Regular
APPLICATION FORM

Course Applied for : B.Sc. (Biotechnology)(Autonomous)(with

Credits) - Regular - CBCS - T.Y.B.Sc. (Biotechnology)(Autonomous) Sem PRN:2021016401464892
V (-)

Application Date : 03/09/2023 Payment Category : 13

1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed KHOLE SAKSHI DINESH
on Mark sheet : [*This name will appear on all University records/documents]
Mother's
Father's/Husband's Name : DINESH NAINITA
Name :
Mother
Marital Status : UnMarried
Tongue :
Place Of Birth : Mumbai Gender : Female Date of Birth (DD/MM/YYYY) : 25/04/2003
Blood Group : Religion : Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
District : Mumbai Location Area : Not
State : Maharashtra Tehsil : Kurla City/Town/Village :
Suburban Available
Address (House
no,street/area/suburb R No 84/B Suswagatam Nagar Postal Colony Chembur Chembur Pin Code : 400071
etc.) :
Contact details
Mobile
917700954417 Email ID: sakshikhole25@gmail.com
Number
2.Legal Reservation Information
Category Type :
Category : OBC
Reserved
Is Guardian from EBC (Economic
Is Specially Abled? No
Backward Class)? No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem V
BSCBT001 - PAPER I BSCBT002 - PAPER II
BSCBT003 - PAPER III BSCBT004 - PAPER IV
Sem VI

BSCBT005 - PAPER V BSCBT006 - PAPER VI

BSCBT007 - PAPER VII BSCBT008 - PAPER VIII

Medium of Instruction : English

4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 120000
5.Educational Details
Month and Exam
Name of Name of Board/University Name of Certificate Mark Out
Year of Seat CGPA %
Examination and State of University School/College No. Obtained of
Passing No.
MAHARASHTRA STATE
BOARD OF SECONDARY
Std 10th March 2018 -- -- 472.00 500.00 -- - -- 94.40
AND HIGHER SECONDARY
EDUCATION,
MAHARASHTRA STATE
Std 12th 12Th BOARD OF SECONDARY February
-- -- 448.00 650.00 -- - -- 68.92
(Science) AND HIGHER SECONDARY 2020
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 Sun Sep 03 2023 22:05:06 GMT+0530 (India Standard Time)