Form No. APP/SSCASC/3320 SEVA SADAN'S Receipt No.
SSCASC/1539
SEVA SADAN COLLEGE OF ARTS, SCIENCE & COMMERCE
ULHASNAGAR - 421 003.
PRN. : APPLICATION FOR ADMISSION : 2021-2022
Registration
Full Fees Roll No . :
No.:SSCASC/1576
Category : Open SY(BMS) Date of Birth : 25-08-2003
Sub Caste : Bengali (as per School Leaving Certificate)
Attaching copy of Certificate is compulsory Gender : Male
No. of Child : 0 Martial Status : Single
Total Annual Income : 200000
I.C. No. :
DD No. : Name of Bank : Amount :
Particulars :
Full Name : DEBASHISH RAJU KARMOKAR Mother Name :
1)
Suparna Jhorna Karmokar
Full Name (in Devnagari) :
2)
Place of Birth
3)
Ulhasnagar
Taluka : Thane Dist. : Thane State : MAHARASHTRA
Place of Domicile
Thane
Religion : Hindu 5) Nationality :
4)
Indian
Local Address :
6)
Shree Balaji Tower/ A-Wing / 605 Murbad road
Phone : Mobile : 9096508877
Permanent Address (Native Place) :
7)
Shree Balaji Tower/ A-Wing / 605 Murbad road
Taluka : Thane Dist. : Thane State : MAHARASHTRA
a) Name of Father :
8)
Raju Dhananjay KARMOKAR
b) Occupation & Office Address : BUSINESS
Phone : 9096508877 Father's Mobile :
9322503353
Wheter Student is Employed (No Concession will be given in attendance to employed students) :
9)
No
10)I give in the table below, information regarding examinations I have passed :
Degree/Diploma Name of Year Month
Name of Roll No./Seat Total Marks/Out
Certificate School/College of
Board/University No. of
Course from which appeared Passing
MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY
SSC Sacred heart school 2019 A064264 /
EDUCATION,Maharashtra
HSC Maharashtra state board of secondary and higher secondary education Priti Academy 2021 M159192 /
The last examination in which I passed / in which I failed / in which I did not appear is
Passed
Exam name & From Which College
I want to Join
DLLE
Bank A/c No : Name of the bank : Branch :
IFSC Code : Aadhar Card No :
645005540158
11)Details of Subjects offered :
Auditing, Financial Institutions and Markets, Production and Total Quality Management,
Business Economics-II, Business Research Methods, Foundation Course-IV, Information
Technology in Business Management-II, Event Marketing, Integrated Marketing
Communication, Introduction to Cost Accounting, Basics of Financial Services, Strategic
Management, Accounting for Managerial Decisions, Business Planning & Entrepreneurial
Management, Foundation Course-III, Information Technology in Business Management-I,
Advertising, Consumer Behaviour
12)Subject Combination :
Finance Electives Finance Electives2
13)Medium of Instruction:
14)University Application No.:
I enclose here with Two duly attested Xerox Copies of following documents and origional HSC Marksheet for FY
15)
Admission.
i) Marksheet of SSC / HSC / E-Ticket
(Outside students seeking admission of F.Y. should attach origional copy of L.C. along with 2 Xerox copies.)
ii) EBC/PTW/STW/Ex. Serviceman and Reserved Category students only
1) Caste Certificate (2) Ration Card (3) Income Certificate or the certificate issued by Tehsildar. (4) School Leaving
Certificate (5) Domicile Certificate if the candidate from other state. (6) Photocopy of Aadhar Card / Receipt
Fee Particulars Payment Mode Transaction No. Amount Date
Registration Form Fee Online Payment 0a110641654837734137 100.0 10-06-2022
UNDERTAKING
N.B. 75% Attendance is compulsary
At the desire of my Parent / Guardian, I wish to apply for admission as per particulars No.1. I have read the prospectus and
hereby agree and undertake to abide by all the rules of institution under ordinance 119. I undertake to attend lectures and
practicals for atleast 75% of the working days of the College in each term and under ordinance 125, I undertake to complete
to the satisfaction of the Principal, the courses of the study of the College prescribed for both and shall pass atleast in all
internal examination in the course of each term under the Mumbai University Circular no. 281, dated 24th April, 1980 failing
which my terms may not be granted and my application form for admission to the University examination may not sent.
Date : Signature of Student
Sir / Madam,
The applicant is my son / daughter / ward. The information submitted above is correct. I request that he/she may kindly be
admitted
Yours Faithfully,
Date : Signature of Parent / Guardian
