Student Profile Form

Faculty of Technology &

Engineering Application No: 562874097383

The Maharaja Sayajirao

University of Baroda

Fatehgunj, Vadodara-390 002,

Gujarat (India)
Academic Year: 2022-2023

APPLICATION
FORM
Course Applied for : Master of Engineering in Metallurgical and Materials (Welding Technology) - Master of Engineering-I (Welding
Technology) - First Semester of ME-I (Welding Technology) - Metallurgical and Materials (Welding Technology)
Application Date : 26-06-2022

1. Personal Information

Last Name : Bhavsar First Name : Yashkumar Middle Name : Jagdishchandra

Gender : Male Religion : Hindu Marital Status : Unmarried

Mother Tongue : Name as per Marksheet : BHAVSAR Date of Birth (DD/MM/YYYY) :

Gujarati YASHKUMAR JAGDISHCHANDRA 17-09-1999

Weight :
Blood Group : O+ Height : 185 Major Thalassemia Status : No Thalassemia
78
Is Student NRI/ Foreign
Country Of Citizenship : India
National : No
Passport No :
Aadhar No : 9880-7679-3733 Name of Aadhar : Yashkumar Bhavsar
U6672848
Permanent Address : 302/Raghukul Square, Opp-Mohini corner, Saheed chowk, Nandalaya road, Vallabh vidyanagar,
District : City/Town/Village :
Country : India State : Gujarat Pin Code : 388120
Anand Vallabh vidyanagar
Current Address : 302/Raghukul Square, Opp-Mohini corner, Saheed chowk, Nandalaya road, Vallabh vidyanagar,
District : City/Town/Village :
Country : India State : Gujarat Pin Code : 388120
Anand Vallabh vidyanagar
Father's/Husband's Name : JAGDISHCHANDRA BHERUBHAI
Mother's Name : HEMLATTABEN JAGDISHCHANDRA BHAVSAR
BHAVSAR
Social Category Name : Guardian Social Category :
Guardian Name : -- Guardian Contact No : -- Family Annual Income : 80000
Father Occupation :
Mother Occupation : House Work Guardian Occupation :
Others
Is Gardian EBC : No Guardian Annual Income : 0
CONTACT DETAILS
Email ID: Yashkumar.Bhavsar@outlook.com Mobile Number : 9265168592 Optional Mobile Number : --
Is Sms
Is Local To Vadodara : No
PermissionGiven : Yes
Is EWS : Yes EWS Doc : 8021072304_EWS.pdf
2.Legal Reservation Information

Reservation Category : General

Is Physically Challenged : No Is Self Emp : Yes
Disability Percentage : 0 Disability Type : --

3.Education Details

Month &
Education
Sr.No. Board/ University Name of School/ College Year of Class CGPA Percentage Document
Level
Passing
Under
Gujarat Technlogical Birla Vishvakarma
1 Graduate Jun 2021 Distinction 8.07 0 View
University Mahavidyalaya, Anand
Degree(UG)
Gujarat secondary and C. V. M. HIGHER
HSC / 12th /
2 Higher Secondary SECONDARY EDUCATION Mar 2017 First Class 0 72.77 View
Intermediate
Education Board COMPLEX
Gujarat secondary and
M. U. Patel Technical High
3 SSC / 10th Higher Secondary Mar 2015 First Class 0 71.83 View
school
Education Board

4.Add On Details

No Records for Display

5.Group Preference Details

No Records Available for Group Preference.

6.Institute Preference Details

Sr.No. Institute Name Preference No.

1 Faculty of Technology & Engineering-(3386) 1

7.Documents

Common Documents
Photo Id : View
Date Of Birth : View
Aadhar Card : View
Category Document : Not Uploaded
Reservation Category : Not Uploaded
EWS : View
Disability Doc : Not Uploaded
Applicant Photo : View
Applicant Signature : View
Required Submitted Documents
Thalessemia Screening Report (TSR)/Receipt of undergoing TSR : View
 Caste certificate (For SC / ST / SEBC) issued by competent authority (If not uploaded, then the candidature will be considered under
OPEN/General category) : View
Valid Photo Identity Card (Compulsory) : View
Attempt Certificate of H.S.C. (Std. XII) : View
Attempt Certificate of S.S.C. (Std. X) (Compulsory) : View
H.S.C. Examination (Std. XII) Mark-sheet : View
S.S.C. Examination (Std. X) Mark-sheet (Compulsory) : View
Under-Graduate Marksheet (Compulsory) : View
Final Marksheet of Diploma Course : Not Uploaded
Non Creamy Layer Certificate-Non Creamy Layer (NCL) certificate of the family, valid as per State Government Rules, issued by
competent authority : Not Uploaded

Additional Documents
No Records Available for Additional Documents.

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
that I need to obtain and produce all the required documents.
I herewith declare that after passing qualifying examination, I have not secure admission elsewhere.
I Application No : 562874097383 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. "I hereby
confirm that I will
SUBMIT SYSTEM GENERATED APPLICATION-FORM along with necessary enclosures required to verify the Academic credentials and
Personal details (Like
Mark-sheets, Degree Certificates, Caste Certificates-if applicable...etc.) to the concerned Faculty/College under which I have applied
through this application,
at the time of "Merit- based Admission Schedule/Spot Admission Schedule" as available under the Prospectus/Published on the University
website as notified
by the concerned Dean of the Faculty/Principal of the College."
I will undergo Thalassemia Test before the First Semester Examination. I hereby declare that I shall refrain from engaging in any behavior
or activity that is
prohibited as per the university regulations.

Note: Candidate must carry two copies of above printout of his/her “Application Form” at the time of entrance test/merit based
admissions, along with the
self-attested copies of all required documents, as mentioned in the respective prospectus and identical photograph pasted at the
appropriate place.On one
copy of the application form , Candidate signs partially on the photograph and partially out side at the time of handing over the form.
Completing the online application form does not guarantee admission in that particular course/program. All admissions are through
entrance test/merit as
per the requirement of the program and faculty norms. See Faculty Prospectus for Details.
Place : Date : ( Signature of the Candidate ) :
For College/Institute/Study Center Use Only
Designation Remarks / Particulars / Recommendations Signature and Date
Admission Clerk
Admission Committee
Accountant/Cashier/
Registrar/ Amount Received: Rs. 700.00/- Date: 13-07-2022
Office Superintendent