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Pragat Samajik Shikshan Society Sanchalit Dr Babasaheb Ambedkar Science Mahavidyalya (893)
Application No :
University of Mumbai
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
174858
Academic Year: 2024-2025 Regular
APPLICATION FORM

Course Applied for : B.M.S.(with Credits) - Regular - Rev16 - PRN:2022016400472536

T.Y.B.M.S. Sem V [2M00155] (22300005)

Application Date : 26/07/2024 Payment Category : 13

1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed SINGH ANSH KUMAR SAROJ
on Mark sheet : [*This name will appear on all University records/documents]
Mother's
Father's/Husband's Name : SAROJ KUMAR MEENU
Name :
Mother
Marital Status : UnMarried
Tongue :
Place Of Birth : Gender : Male Date of Birth (DD/MM/YYYY) : 19/05/2003
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 : Palghar Tehsil : Vasai City/Town/Village :
Available
Address (House
FLAT NO 203 B WING JULIUS PARK INSIDE VIJAY PARADISE NEAR PUNJAB
no,street/area/suburb Pin Code : 401208
NATIONAL BANK GOKHIWARE
etc.) :
Contact details
Mobile
8830697887 Email ID: anshk65075@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 [2M00155]
46001 - Logistics and Supply Chain Management 46002 - Corporate Communication and Public Relations
46004 - Services Marketing 46007 - E-Commerce & Digital Marketing
46010 - Sales and Distribution Management 46013 - Customer Relationship Management
Sem VI [2M00156]

86001 - Operation Research UBMSFSVI.5 - Project Work

86003 - Brand Management 86006 - Retail Management
86009 - International Marketing 86012 - Media Planning and Management

Medium of Instruction : English

4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 100000
5.Educational Details
Month Exam
Name of Name of Board/University Name of Certificate Mark Out
and Year Seat CGPA %
Examination and State of University School/College No. Obtained of
of Passing No.
MAHARASHTRA STATE
BOARD OF SECONDARY March
Std 10th -- -- 406.00 500.00 -- - -- 81.20
AND HIGHER SECONDARY 2020
EDUCATION,
MAHARASHTRA STATE
Std 12th 12Th BOARD OF SECONDARY
June 2022 -- -- 383.00 600.00 -- - -- 63.83
(Commerce) AND HIGHER 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 Sun Jul 28 2024 20:44:27 GMT+0530 (India Standard Time)