For Office Use
Batch:                              Scrutiny                        Payment: Online/DD           PI
                      Serial:
     Only
                            R. D. National College of Arts and Commerce and W. A. Science College (163)
                                             Linking Road, 32 ND Tps III, Opp. Barista. Mumbai                              Application No :
                                                             University of Mumbai
                                           M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
                                                                                                                                 351513
                                                       Academic Year: 2022-2023                                                   Regular
                                                              APPLICATION FORM
Course Applied for : B.M.S.(with Credits) - Regular - Rev16 - F.Y. B.M.S. Sem I (22300005)                         PRN:
Application Date : 14/06/2022                    Payment Category :
1.Personal Information
Candidate's Name(Regional) :                     श्रुती
                                                 SHRUTI
Candidate's Name as printed on
                                                 [*This name will appear on all University
Mark sheet :
                                                 records/documents]
Father's/Husband's Name :                        KRISHNA                   Mother's Name :       VARA
Marital Status :                                 UnMarried                 Mother Tongue :       Telugu
Place Of Birth : BHIWANDI                        Gender : Female               Date of Birth (DD/MM/YYYY) : 20/08/2004
Blood Group : BNegative                          Religion : Hindu              Country of Citizenship : India
Is Student NRI/ Foreign National : No                                                       Domicile State: Maharashtra
Address For Correspondence :
                                                                                                 City/Town/Village :        Location Area :
State : Maharashtra               District : Palghar                 Tehsil : Vasai
                                                                                                 Nallasopara                Semiurban
Address (House
no,street/area/suburb             B/001 Plot No. 26 Priyanka CHSL. Central Park Nallasopara East More                       Pin Code : 401209
etc.) :
Permanent Address :
                                                                                                 City/Town/Village :        Location Area :
State : Maharashtra               District : Palghar                 Tehsil : Vasai
                                                                                                 Nallasopara                Semiurban
Address :                         B/001 Plot No. 26 Priyanka CHSL. Central Park Nallasopara East More                       Pin Code : 401209
Contact details
Mobile
                       7559266199                                                                   Email ID: shrutiadep599@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 I
  UBMSFSI.1 - Introduction to Financial Accounts                                  UBMSFSI.2 - Business Law
  UBMSFSI.3 - Business Statistics                                                 UBMSFSI.5.1 - Foundation Course I
  UBMSFSI.4 - Business Communication I                                            UBMSFSI.6 - Foundation of Human Skills
  UBMSFSI.7 - Business Economics I
  Sem II
          UBMSFSII.1 - Principles of Marketing                                        UBMSFSII.2 - Industrial Law
          UBMSFSII.3 - Business Mathematics                                           UBMSFSII.5.1 - Foundation Course II
          UBMSFSII.4 - Business Communication II                                      UBMSFSII.6 - Business Environment
          UBMSFSII.7 - Principles of Management
Medium of Instruction : English
4.Guardian Information
Occupation of Guardian : Service                                Annual Income of Guardian : 180000
5.Educational Details
                                                         Month
  Name of   Name of Board/University and    Name of     and Year Exam Certificate  Mark                          Out
                                                                                                                          CGPA      %
Examination     State of University      School/College    of    Seat No. No.     Obtained                        of
                                                         Passing
                 MAHARASHTRA STATE BOARD
Std 12th         OF SECONDARY AND HIGHER          CHETANA          June
                                                                             M257158 3201008         378.00     600.00 -- - --   63.00
Commerce         SECONDARY                        COLLEGE          2022
                 EDUCATION,Maharashtra
                 MAHARASHTRA STATE BOARD
                 OF SECONDARY AND HIGHER          INFANT JESUS
Std 10th                                                       July 2020 A173393 --                  408.00     500.00 -- - --   81.60
                 SECONDARY                        HIGH SCHOOL
                 EDUCATION,Maharashtra
Your Last Qualifying Exam: HSC/Std 12th [Commerce]
7.Other Information
Would you like to apply for Hostel accommodation required                                                                 NA
Required Documents and Certificates Section:
     Passing Certificate of Std 12th / Statement of Marks of Std 12th OR Original Passing Certificate /Statement of Marks of Last
     Qualifying Exam like degree,diploma,etc.
     Passing Certificate of Std 10th.
     Leaving Certificate.
     Birth Certificate.
     Passing Certificate of Std. 10th.
     Passing Certificate of Std. 12th/Statement of Marks of std.12th.
     School/College Leaving Certificate.
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 Application No :351513
(SHRUTI) 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 )
For College/Institute/Study Center Use Only
Designation                                                                                                       Signature and
                      Remarks / Particulars / Recommendations
                                                                                                                  Date
 Admission Clerk
 Admission
 Committee
 Accountant/Cashier Cash Received: INR                                  Receipt No.:                              Date:
 Registrar/Office
 Superintendent
Document printed on Tue Jun 14 2022 21:25:16 GMT+0530 (India Standard Time)