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Application Form: Student SSC Details

This document is an application form for admission to a Master of Commerce program at the University of Mumbai. It contains personal details of the applicant such as name, date of birth, contact information, family details, educational qualifications and marks obtained. It also includes details of the applicant's caste category, income, bank account, documents attached and declarations signed. The form is submitted for the academic year 2015-2016 and contains information needed to process the applicant's admission under the government quota.

Uploaded by

SudamMerya
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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480 views2 pages

Application Form: Student SSC Details

This document is an application form for admission to a Master of Commerce program at the University of Mumbai. It contains personal details of the applicant such as name, date of birth, contact information, family details, educational qualifications and marks obtained. It also includes details of the applicant's caste category, income, bank account, documents attached and declarations signed. The form is submitted for the academic year 2015-2016 and contains information needed to process the applicant's admission under the government quota.

Uploaded by

SudamMerya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Application Form

Application Number

APPSUDAM1991@2015

Appilcation type

New

Please Paste
Passport Size
Photograph
Renewal Course Year N.A

Student SSC Details


SSC Board

MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year

2008

SSC Seat No

E088459

SSC Marks Obtained

57.84

Applicant's Details
285325920591

UID Number

UID Enrollment Number

Applicant Name SUDAM

Date of Birth

MANGAL

Mother's
Name

MERYA

first name

middle name

12-07-1991

Gender

PARVATI MANGAL
MERYA

last name

Is Resident of Maharashtra Yes

Male

Academic Year 2015-2016

Application Date 15-09-2015

Caste Category Scheduled Tribe


Caste

Warli

Sub Caste

Orphan

No

Is Disabled

Is Applicant
Salaried ?

No

Maritial Status

No

N.A

No

Disability Type

N.A.

Applicant's
0.00
Annual Income

Total Annual
Income

60000.00

Is Staying at
Hostel ?

Has Applied For No


Hostel ?

No

Student Prequalifying Details


Last attended School/College/Institute

DEPARTMENT OF COMMERCE UNIVERSITY OF MUMBAI

Last Exam Passed

Master of comm. part 1

Passed

Yes

Last Exam Passed


Year

2015

Last Exam
Marks

56

Institution Details
Name of School/College/Institute
where Admitted

Registrar,University Of Mumbai,Dept.Of Commerce,Santacruz(E),Mum-98

Course Name

Master of Commerce

Subject

N.A

Academic Year

2015-2016
15-06-2015

College Admission 24247


Number

Date Of
Admission

03-06-2015

Joining Date

Is Fees Paid ?

No

Fee Paid

0.00

Fee Receipt No.

Fee Receipt Date

N.A

Course Year 2

GrantType

Granted

Is Admission after Diploma

Quota

N.A
Government
Quota

No

Contact Details
Residential Number: N.A, MobileNumber: 8408998190, EmailAddress: sudamty77@gmail.com
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Address For Correspondence


Address:- KAINAD
Thane

Location:- KAINAD

City:- KAINAD

Pincode:- 401602

Taluka:-

District:-

Parent / Guardian Details


Parent's name

MANGAL

RUPJI

first name

middle name

Relation with Applicant Father


Parmanent Address

MERYA

Parent Age

last name

55(yrs)

Profession

Agricultural, fishery
and related labour
Parents Annual 60000.00
Income

KAINAD

Hostel Information
Name of Landlord /
Hostel
Hostel Type

N.A

N.A

Is Mess Service Available?

Hostel/ Landlord N.A


Address
Is Studying in night school

No

Hostel Admission
Date

N.A

Rent Per Month

N.A

Hostel/Landlord
Contact Details

N.A

No

Document Details
Caste Certificate
No
Caste Validity
Certificate No

N.A

Income
Certificate No

District Issuing
Office

Thane

Taluka Issuing
Office

Dahanu

District Issuing
Office

Thane

Scrutiny
Committee No

N.A

Issued in

2015

University
Registration No

N.A

Student Bank Account Details


Bank Name

CORPORATION BANK

Branch Name

MUMBAI - SANTACRUZ (EAST)

IFSC Code

CORP0000499

Bank
Account No

049900101112922

MICR Code

400017038

Document Attached
Caste Certificate Issued by Competant Officer
Income Proof - Income Certificate Issued by Competant Authority
Marksheets
I-card Size Photo
Caste Validity Certificate
SSC Mark Sheet
UID Number
Declaration
The information furnished by me is complete and correct. I bear the complete responsibility for all the above
information.
Applicant's Signature

_______________________

Principal's Signature

_______________________

Applicant Parent's Signature

_______________________

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