Escolar Documentos
Profissional Documentos
Cultura Documentos
ApplicationformPrintout
[STUDENTCOPY]
ApplicationFormNumber:1279833
Arts,CommerceandScienceCollegeSindhudurg
VidyaBhavan,MumbaiGoaExpressRoad,JaitapkarColony,Oros.,Sindhudurnagari
UniversityofMumbai
B.A.(withCredits)RegularC7525F.Y.B.A.F.Y.B.A.SemI
(MediumMarathi)
ApplicationForm1279833
1.PersonalInformation
NameofApplicant:
PARABANJALIPRAMOD
Father's/Husband'sName(MiddleName):
PRAMOD
DateofBirth:
28Dec1995
Gender:
PlaceofBirth:
MALVAN
MobileNumbers:9404141317
AddressforCorrespondence:
A/PMALVANVERAL,City:MALVAN,Taluka:Malvan,District:Sindhudurg,State:Maharashtra,
Country:India,Pin:416606
ContactNumber:
NotAvailable
Female
Mother'sFirstname:
SUPRIYA
MaritalStatus:
UnMarried
EmailId:NotAvailable
SocialReservationInformationofApplicant:
2.PapersSelectedfor:F.Y.B.A.
[UBA1.3]Marathi
[UBA1.35]PaperIEconomicsTheory
[UBA1.42]PaperIMarathi
[UBA1.28]PaperIHistoryofModern
Maharashtra18481960AD
[UBA1.1]SocialAwareness,PersonalityDevelopment&
CurrentAffairsI(F.C.I)
[UBA1.2]PaperICommunication
SkillsinEnglish
3.EducationalDetailsSection
Nameof
Examination
Stream
NameofBoard/University
SchoolName
Dateof
Passing
Grade/Total
Seat Qualifying
Marks
Number
Exam
Obtained
10th
NA
MAHARASHTRASTATEBOARD NEWENGLISHSCHOOL
OFSECONDARYANDHIGHER MALVAN
SECONDARYEDUCATION
Apr2012
364/550
12th
Commerce
MAHARASHTRASTATEBOARD JR.COLLEGEMALAGOAN
OFSECONDARYANDHIGHER
SECONDARYEDUCATION
Feb2014 346/650
B031669
W026554
4.RequiredDocumentsandCertificatesSection(Pleasetickmarkthedocumentthatyouhaveattachedtothisform)
PassingCertificateofStd10th.
LeavingCertificate.
5.DeclarationbyApplicant
Iherebydeclareandagreethat,
1. ThisApplicationmostlyincludeallthemajorCoursesandCollegesoftheUniversity.However,iftheCoursesandCollegesoftheUniversityarenotlistedinthe
application,thenitismyresponsibilitytocontacttheCollegeseparatelyforapplyingfortheCoursesthatarenotlisted.
2. Iknow,UniversitymayaddaffiliationtonewCollegesoraffiliatenewCoursetoexistingCollegesaftermyapplication.ItwillbenotifiedthroughaCorrigendum
onportal.ItismyresponsibilitytocheckthesameregularlyandapplyforthenewlyaddedCourse/College,ifinterested.
3. Ihavereadtherulesrelatedtoadmissionandtheinformationfilledinbymeinthisformisaccurateandtruetothebestofmyknowledge.Iwillberesponsible
foranydiscrepancy,arisingoutoftheformsignedbymeandunderstandthat,intheabsenceofanydocument,thefinaladmissionwillnotbegrantedand/or
admissionwillstandcancelled.
IamawareoftheAntiRaggingActandIstatethatIwillabidebyalltherulesandregulationofthesaidAct.
Place:
Date:
SignatureoftheApplicant:
6.DeclarationbyParent/Guardian
Ihavepermittedmyson/daughter/wardtoapplyinyourCollege.Theinformationsuppliedbyhim/heriscorrecttothebestofmyknowledge.I
haveacquaintedmyselfwiththerulesandfees/duesrelatedtotheprogram.
Place:
Date:SignatureoftheGuardian:
7.ForCollege/InstituteUseOnly
Designation
Remarks/Particulars/Recommendations
SignatureandDate
AdmissionClerk
Admission
Committee
Accountant/Cashier CashReceived:Rs.
ReceiptNo.:
Registrar/Office
Superintendent
Note:AftersubmittingCollegeCopyofApplicationForm,pleasetaketheAcknowledgementfromthecollegeonStudentCopyofApplicationForm.
http://mumadmission.digitaluniversity.ac/OnlineAdmissions/PrintApplication.html
1/2
10/27/2015
ApplicationformPrintout
[SUBMISSIONCOPY]
ApplicationFormNumber:1279833
Arts,CommerceandScienceCollegeSindhudurg
VidyaBhavan,MumbaiGoaExpressRoad,JaitapkarColony,Oros.,Sindhudurnagari
UniversityofMumbai
B.A.(withCredits)RegularC7525F.Y.B.A.F.Y.B.A.SemI
(MediumMarathi)
ApplicationForm1279833
1.PersonalInformation
NameofApplicant:
PARABANJALIPRAMOD
Father's/Husband'sName(MiddleName):
PRAMOD
DateofBirth:
28Dec1995
Gender:
PlaceofBirth:
MALVAN
MobileNumbers:9404141317
AddressforCorrespondence:
A/PMALVANVERAL,City:MALVAN,Taluka:Malvan,District:Sindhudurg,State:Maharashtra,
Country:India,Pin:416606
ContactNumber:
NotAvailable
Female
Mother'sFirstname:
SUPRIYA
MaritalStatus:
UnMarried
EmailId:NotAvailable
SocialReservationInformationofApplicant:
2.PapersSelectedfor:F.Y.B.A.
[UBA1.3]Marathi
[UBA1.35]PaperIEconomicsTheory
[UBA1.42]PaperIMarathi
[UBA1.28]PaperIHistoryofModern
Maharashtra18481960AD
[UBA1.1]SocialAwareness,PersonalityDevelopment&
CurrentAffairsI(F.C.I)
[UBA1.2]PaperICommunication
SkillsinEnglish
3.EducationalDetailsSection
Nameof
Examination
Stream
NameofBoard/University
SchoolName
Dateof
Passing
Grade/Total
Seat Qualifying
Marks
Number
Exam
Obtained
10th
NA
MAHARASHTRASTATEBOARD NEWENGLISHSCHOOL
OFSECONDARYANDHIGHER MALVAN
SECONDARYEDUCATION
Apr2012
364/550
12th
Commerce
MAHARASHTRASTATEBOARD JR.COLLEGEMALAGOAN
OFSECONDARYANDHIGHER
SECONDARYEDUCATION
Feb2014 346/650
B031669
W026554
4.RequiredDocumentsandCertificatesSection(Pleasetickmarkthedocumentthatyouhaveattachedtothisform)
PassingCertificateofStd10th.
LeavingCertificate.
5.DeclarationbyApplicant
Iherebydeclareandagreethat,
1. ThisApplicationmostlyincludeallthemajorCoursesandCollegesoftheUniversity.However,iftheCoursesandCollegesoftheUniversityarenotlistedinthe
application,thenitismyresponsibilitytocontacttheCollegeseparatelyforapplyingfortheCoursesthatarenotlisted.
2. Iknow,UniversitymayaddaffiliationtonewCollegesoraffiliatenewCoursetoexistingCollegesaftermyapplication.ItwillbenotifiedthroughaCorrigendum
onportal.ItismyresponsibilitytocheckthesameregularlyandapplyforthenewlyaddedCourse/College,ifinterested.
3. Ihavereadtherulesrelatedtoadmissionandtheinformationfilledinbymeinthisformisaccurateandtruetothebestofmyknowledge.Iwillberesponsible
foranydiscrepancy,arisingoutoftheformsignedbymeandunderstandthat,intheabsenceofanydocument,thefinaladmissionwillnotbegrantedand/or
admissionwillstandcancelled.
IamawareoftheAntiRaggingActandIstatethatIwillabidebyalltherulesandregulationofthesaidAct.
Place:
Date:
SignatureoftheApplicant:
6.DeclarationbyParent/Guardian
Ihavepermittedmyson/daughter/wardtoapplyinyourCollege.Theinformationsuppliedbyhim/heriscorrecttothebestofmyknowledge.I
haveacquaintedmyselfwiththerulesandfees/duesrelatedtotheprogram.
Place:
Date:SignatureoftheGuardian:
7.ForCollege/InstituteUseOnly
Designation
Remarks/Particulars/Recommendations
SignatureandDate
AdmissionClerk
Admission
Committee
Accountant/Cashier CashReceived:Rs.
ReceiptNo.:
Registrar/Office
Superintendent
http://mumadmission.digitaluniversity.ac/OnlineAdmissions/PrintApplication.html
2/2