Shikshana Prasaraka Mandali's

SIR PARASHURAMBHAU COLLEGE

(Established in 1916)
ARTS | SCIENCE | COMMERCE
Accredited with A+ Grade(3.70 CGPA)by NAAC

Admission Form Details (Academic Year :2023-2024)

Form Verification(For Office Use Only) Print Date : 10/11/2023 12:11:15 AM

B 3183 SYJC (Science-Aided-Vocational) Yes

Sign.
Div & Subject Alot. Auth Division Roll No. Class Is SP College

231230123 Clerk OPEN OPEN No

Sign.
Form No. Scholarship Verification Fee Category Caste Category Is Handicapped

Registration Information

Form Number :231230123

Roll No.(11th): Division (11th):
183 B

Admission Type : Section : Class :

Provisional Junior SYJC (Science-Aided-Vocational)

Division : Fee Category Caste Category

OPEN OPEN

Adhaar Card No: School Udise No: Board

808025452629 27290101809 Maharastra Board

Personal Details
Name : SHINDE SARWAM GANESH

Gender : Male Female Transgender Blood Group : DONT KNOW

Religion : Hindu

Caste : maratha Minority : Yes No

Email ID : shindesawam12@gmail.com

Date of Birth : 21/10/2006

Birth Place : bhoom

Marital Status : Unmarried Mobile No.: 8275304374

Occupational Status : Unemployed

Fee Concession :

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 Contact Information
Address Line 1 : SAMARTH NAGAR

Address Line 2 : SAMARTH NAGAR

Name of Village/Town/City : BHOOM District: OSMANABAD

State : MAHARASHTRA Country : INDIA

Pin Code : 413504

Parent Information
Father's Mobile Number : 8275304374 Mother's Mobile Number : 8830984392

Father's Full Name : GANESH SHANKARRAO SHINDE

Mother's Name : KSHITIJA

Annual Income of parents(Rs.): 60000

Last Year's Details with (TC/LC)/Migration/Eligibility Information

Name and City of
Month of Year of Marks Out of Percentage Name of
Class School/College
Passing Passing Obtained Marks (%) Board
where studied
SHRI GURUDEO DATTA
SSC/CBSC 3 2022 469 500 93.80 LATUR
HIGHISCHOOL BHOOM

FYJC 5 2023 299 600 49.83 SP COLLEGE PUNE Maharastra Board

Have you completed last qualification from SP College? Yes

10th Maths Subject : Regular

Last qualification Number of attempt : 1

Last Qualification Seat No : L095064

Last Qualification T.C/L.C. Date :

Last Qualification T.C/L.C. No.:

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 Subject's Information

Subject Name Subject Code Group Name

English Group A Compulsory Subjects

Physics Group A Compulsory Subjects

Chemistry Group A Compulsory Subjects

Environmental Science Group A Compulsory Subjects

Physical Education Group A Compulsory Subjects

Mathematics & Statistics Group B : select subjects

Electronics I Group D : Vocational Subjects

Electronics II Group D : Vocational Subjects

List of Documents Attached

1) AADHAAR Card 2) Marksheet

3) Original L.C.

SHINDE SARWAM GANESH SHINDE SARWAM GANESH

Scanned Signature Student's Signature

Undertaking
We hereby certify that the information provided in this application form is correct.We undertake to abide
by the rules and regulations of the college and the orders issued by the cometent authorities from time to time.
We are agree that decision of the principal in respect of the student's admission will be binding upon us.

Parent's Signature Student's Signature

Admission Admission Not

Principal's/Vice Principal's/Authority Signature Confirmed Confirmed

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 SHIKSHANA PRASARAKA MANDALI'S SHIKSHANA PRASARAKA MANDALI'S
SIR PARASHURAMBHAU COLLEGE SIR PARASHURAMBHAU COLLEGE
Tilak Road,Pune- 411 030 Tilak Road,Pune- 411 030
A (College Copy) Challan No : 231230123 B (Bank Copy) Challan No : 231230123
Academic Year : 2023-2024 Academic Year : 2023-2024
Janata Sahakari Bank Ltd. Tilak Road Branch Janata Sahakari Bank Ltd. Tilak Road Branch
College A/c. No. : ECS014230100003261 College A/c. No. : ECS014230100003261
Name : SARWAM GANESH SHINDE Name : SARWAM GANESH SHINDE

Class : SYJC (Science-Aided-Vocational) Class : SYJC (Science-Aided-Vocational)

Roll No : 3183 Div: B Roll No : 3183 Div: B

Fee Category : OPEN Fee Category : OPEN

The sum of Rs. : 6150.00 /- The sum of Rs. : 6150.00 /-
Rupees SIX THOUSAND ONE HUNDRED Rupees SIX THOUSAND ONE HUNDRED
(in words). : AND FIFTY ONLY. (in words). : AND FIFTY ONLY.

Signature Of Student : Signature Of Student :

No Amount No Fee Head Amount

1 Admission Fee 0.00 1 Admission Fee 0.00

2 Tution Fee 240.00 2 Tution Fee 240.00

3 Term Fee 40.00 3 Term Fee 40.00

4 Laboratory Fee 70.00 4 Laboratory Fee 70.00

5 S.W.F. 50.00 5 S.W.F. 50.00

6 Other Activity 300.00 6 Other Activity 300.00

7 Examination Fee 500.00 7 Examination Fee 500.00

8 College Dev. Fee 2700.00 8 College Dev. Fee 2700.00

9 Student Activity 500.00 9 Student Activity 500.00

10 Science Fee 300.00 10 Science Fee 300.00

11 H.S.C. Exam Fee 0.00 11 H.S.C. Exam Fee 0.00

12 Handbook 0.00 12 Handbook 0.00

13 Online Processing Fee 250.00 13 Online Processing Fee 250.00

14 Vocational Fee 1200.00 14 Vocational Fee 1200.00

15 N.G. Fee 0.00 15 N.G. Fee 0.00

Total : Rs. 6150.00 /- Total : Rs. 6150.00 /-

 SHIKSHANA PRASARAKA MANDALI'S
SHIKSHANA PRASARAKA MANDALI'S
SIR PARASHURAMBHAU COLLEGE
SIR PARASHURAMBHAU COLLEGE
Tilak Road,Pune- 411 030
Tilak Road,Pune- 411 030
C (Student Copy) Challan No : 231230123
D (Form Copy) Challan No : 231230123
Academic Year : 2023-2024
Academic Year : 2023-2024
Janata Sahakari Bank Ltd. Tilak Road Branch
Janata Sahakari Bank Ltd. Tilak Road Branch
College A/c. No. : ECS014230100003261
College A/c. No. : ECS014230100003261
Name : SARWAM GANESH SHINDE
Name : SARWAM GANESH SHINDE
Class : SYJC (Science-Aided-Vocational)
Class : SYJC (Science-Aided-Vocational)
Roll No : 3183 Div: B
Roll No : 3183 Div: B
Fee Category : OPEN
Fee Category : OPEN
The sum of Rs. : 6150.00 /-
The sum of Rs. : 6150.00 /-
Rupees SIX THOUSAND ONE HUNDRED
(in words). : AND FIFTY ONLY. Rupees SIX THOUSAND ONE HUNDRED
(in words). : AND FIFTY ONLY.
Signature Of Student :
Signature Of Student :

No Fee Head Amount No Fee Head Amount

1 Admission Fee 0.00 1 Admission Fee 0.00

2 Tution Fee 240.00 2 Tution Fee 240.00

3 Term Fee 40.00 3 Term Fee 40.00

4 Laboratory Fee 70.00 4 Laboratory Fee 70.00

5 S.W.F. 50.00 5 S.W.F. 50.00

6 Other Activity 300.00 6 Other Activity 300.00

7 Examination Fee 500.00 7 Examination Fee 500.00

8 College Dev. Fee 2700.00 8 College Dev. Fee 2700.00

9 Student Activity 500.00 9 Student Activity 500.00

10 Science Fee 300.00 10 Science Fee 300.00

11 H.S.C. Exam Fee 0.00 11 H.S.C. Exam Fee 0.00

12 Handbook 0.00 12 Handbook 0.00

13 Online Processing Fee 250.00 13 Online Processing Fee 250.00

14 Vocational Fee 1200.00 14 Vocational Fee 1200.00

15 N.G. Fee 0.00 15 N.G. Fee 0.00

Total : Rs. 6150.00 /- Total : Rs. 6150.00 /-

 ANTI RAGGING AFFIDAVIT BY THE STUDENT

Unique Form No.: 231230123 Date: 10/11/2023 12:11:16 AM

1. I,SHINDE SARWAM GANESH S/O or D/O Mr./Mrs./Ms

GANESH SHANKARRAO SHINDE having been admitted to Shikshana Prasaraka Manali's
SIR PARASHURAMBHAU COLLEGE have received copy of UGC Regulations on Curbing the Menace
of Ragging in Higher Educational carefully read and fully provisions contained in the said Regulations.
2. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.
Institutions,2009,(hereinafter called the Regulations)

3. I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the
penaland administrative action that is liable to be taken against me in case I am found guilty of or
abetting ragging, actively or passively, or being part of a conspiracy to promote ragging.

4. I hereby solemnly aver and undertake that I will not indulge in any behaviour or act that may be constituted
as ragging under clause 3 of the Regulations.I will not participate in or abet or propagate through any act
of commission or omission that may be constituted as ragging under clause 3 of the Regulations.
5. I hereby affirm that, if found guilty of ragging,I am liable for punishment according to clause 9.1 of the
Regulations, without prejudice to any other criminal action that may be taken against me under any penal
law or any law for the time being in force.

6. I hereby declare that I have not been expelled or debarred from admission in any institution in the country
on account of being found guilty of,abetting or being part of a conspiracy to promote ,ragging; and further
affirm that ,in case the declaration is found to be untrue, the admission of my is liable to be cancelled.

10/11/2023 12:11:16 AM
Declared on

Signature of Student Signature of Parent/Guardian

Name :SARWAM GANESH SHINDE Name :GANESH SHANKARRAO SHINDE

Address : SAMARTH NAGAR SAMARTH NAGAR BHOOM OSMANABAD MAHARASHTRA INDIA 413504

Verification
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the the
affidavit is false and nothing has been concealed or misstated therein.

Verified at on

Signature of Student Signature of Parent/Guardian

(Note : There is no need to get your affidavits printed on any stamp paper or get it signed
by an Notary or an oath Commissioner.)

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