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    Mumbai University Application Form

    Uploaded by

    srushtipatil1216

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Mumbai University Application Form

    Uploaded by

    srushtipatil1216
    7 views2 pages

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    7 views2 pages

    Mumbai University Application Form

    Uploaded by

    srushtipatil1216

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    For Office Use

    Batch: Scrutiny Payment: Online/DD PI

    Serial:
    Only

    PILLAI HOC COLLEGE OF ENGINEERING AND TECHNOLOGY,RASAYANI (822)


    Application No :
    University of Mumbai 524497
    M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
    Academic Year: 2024-2025 Regular
    APPLICATION FORM

    Course Applied for : B.E.(with Credits) - Regular - CBCS - Computer PRN:2023016402429221


    Engineering - S.E. C-Scheme Sem III (BECBCS1001)

    Application Date : 20/10/2024 Payment Category : 25


    1.Personal Information
    Candidate's Name(Regional) :
    Candidate's Name as printed PATIL SRUSHTI VARSHANAND
    on Mark sheet : [*This name will appear on all University records/documents]
    Mother's
    Father's/Husband's Name : VARSHANAND MANISHA
    Name :
    Mother
    Marital Status : UnMarried
    Tongue :
    Place Of Birth : PEN Gender : Female Date of Birth (DD/MM/YYYY) : 01/02/2006
    Blood Group : Religion : Country of Citizenship : India
    Is Student NRI/ Foreign National : No Domicile State: Maharashtra
    Address For Correspondence :
    Location Area : Not
    State : Maharashtra District : Raigad Tehsil : Pen City/Town/Village :
    Available
    Address (House
    no,street/area/suburb 156B HAMRAPUR PEN RAIGAD HAMRAPUR Pin Code : 402107
    etc.) :
    Contact details
    Mobile
    919822574179 Email ID: srushtipatil1216@gmail.com
    Number
    2.Legal Reservation Information
    Category Type :
    Category : OBC
    Reserved
    Is Guardian from EBC (Economic
    Is Specially Abled? No
    Backward Class)? No
    3.Social Information(Additional Inforamtion)
    Not Applicable
    Paper Selected for:
    Sem III
    CSC301 - Engineering Mathematics-III CSC302 - Discrete Structures and Graph Theory
    CSC303 - Data Structure CSC304 - Digital Logic & Computer Architecture
    CSC305 - Computer Graphics CSL301 - Data Structure Lab
    CSL302 - Digital Logic & Computer Architecture Lab CSL303 - Computer Graphics Lab
    CSL304 - Skill Base Lab Course: Object Oriented Programming CSM301 - Mini Project – 1 A
    With Java
    Sem IV

    CSC401 - Engineering Mathematics-IV CSC402 - Analysis of Algorithm


    CSC403 - Database Management System CSC404 - Operating System
    CSC405 - Microprocessor CSL401 - Analysis of Algorithm Lab
    CSL402 - Database Management System Lab CSL403 - Operating System Lab
    CSL404 - Microprocessor Lab CSL405 - Skill Base Lab Courses: Python Programming
    CSM401 - Mini Project 1-B

    Medium of Instruction : English


    4.Guardian Information
    Occupation of Guardian : Farmer Annual Income of Guardian : 85000
    5.Educational Details
    Month Exam
    Name of Name of Board/University Name of Certificate Mark Out
    and Year Seat CGPA %
    Examination and State of University School/College No. Obtained of
    of Passing No.
    MAHARASHTRA STATE
    BOARD OF SECONDARY
    Std 10th July 2021 -- -- 435.00 500.00 -- - -- 87.00
    AND HIGHER SECONDARY
    EDUCATION,
    MAHARASHTRA STATE
    Std 12th 12Th BOARD OF SECONDARY
    June 2023 -- -- 387.00 600.00 -- - -- 64.50
    (Science) AND HIGHER SECONDARY
    EDUCATION,
    Your Last Qualifying Exam:
    7.Other Information
    Would you like to apply for Hostel accommodation required NA
    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 understand that I need to obtain and produce all the required documents. I 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.

    Place : Date :
    ( Signature of the Candidate )
    Document printed on Sun Oct 20 2024 14:23:48 GMT+0530 (India Standard Time)

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