RAIMATA JIUAU SHIKSHAN PRASARAK MANDALS collage Code: a [ARTS,COMMERCE & SCIENCE COLLEGE eae Mandl andewadi Bhosar-411099 18 For College use | course Applied For SYBBA-3 Registration No. ey cd Medium: ENGLISH cide! } Registration Date: 19/07/2023 | E | 1. Personal information section Last Name First Name Middle Name Name of Student SAPKAL NIRA SATISH Fathers Name SAPKAL saTISH AMRUTBHAI Mothers Name: ARCHNA In-House Student: 0 Marital Status: UNMARRIED Sara Wo. Date of Birth: 28/04/2005, Gender: MALE Place of Birth BETUL Blood Group: PLEASE SELECT Grandfathers Name: Native Place: Voter i0 card No Organ Donor: NO Bank Name: ‘Account No Religion: HINDU Nationality INDIAN UDISE Wo. ‘Aachaar card No. 699743640070 Driving Licence No. Eigiblty No. ‘ABC I 1s Orphan: NO ‘Orphan Category 0 Culturarat Activites: 2. Address Details ‘Address of Correspondence: | SR.NO.491/1A NAVALE NIWAS NEAR DIMOND PLASTIC FACTORYKASARWADI PUNE CITY PUNE 411034 ‘State: MAHARASHTRA District: PUNE Tehsil: City: HAVALI Permanent Address: 5|HELI CO.OP SOCIETY.POLICE LINE NEAR PIYUSH Pin Code: 394210 POINT |UDHNA ,CHORASISURAT ‘State: GUJARAT District: SURAT Tehsil: City: CHORASI 3. Contact Details ‘Student Mobile No.: 8000911200 ‘Alternate Contact Number: ‘Student Ema I: SAPKALNIRAJ2005@GMAILCOM Parent phone: 8849931970 4. Legal Reservation Information Section Domicile state: ‘Admission Category: OBC Caste Category: OBC ‘Caste: HINDU DHOB! BAKSHIPANCH Phy. Handicapped: Caste Certificate No.: Learning Disability No.: '5. Social Reservation (Special Category) Information Section SRNo. SOCIAL RESERVATION NAME6. Education Details Section Name of ]Namecf] _Nameof | Dateof Examination Seat] Passing | Grade/Total | Obt. | To. Examination | Board | schooV/College | Passing | __Number__|certificateNo.| Marks _| Marks STATE sc oars | Jeevan tae 470523 750 22 fq 0 7. Qualifying Exam Details Section (QUALIFYING EXAM NAME: a ee eee eS Qualifying Exam Subject Details Sr.No, ‘Subject Name Total Marks, Obtained Marks 8. Subject Details Section Group ‘Subject Name CONSUMER BEHAVIOUR AND SALES MANAGEMENTFUNOAMENTALS OF RURAL DEVELOPMENT:SLOBAL 1 IMarKETING | COMPETENCIES AND PERSONALITY DEVELOPMENTPRINCIPLES OF HUMAN RESOURCE MANAGEMENTRETAIL [MANAGEMENT + BUSINESS EXPOSURE.SUPPLY CHAIN MANAGEMENT ‘Attached Documents SENo. Name of Documents/Certificate 1 -AADHAR CARO 2 Sc MARKSHEET 2 CASTE CERTIFICATE 10, Guardian / Parent information Section Guardiaris/ Parent's Name: ‘Occupation of the Guardian/Parent: ‘Annual income of the guardian/Parent: Relationship of Guardian with applicant: ~ Guardian/Parent Phone No. 8849931970 11, Other Information Section Mother Tongue: GUJARATI Employment Status: NO Do you wish to join NCC / NSS: NO ‘Would you like to apply for Hostel: NO Hobbies, Proficiency and Other interests: NA Games and sports participation: Identification Mark 1:— Identification Mark 2:—12 Declaration by Student | hereby declare that, | have read the rules related to admission and the Information filed in by me in this form is accurate and true to the best of my knowledge. | will be responsible for any discrepancy, arising out of the form signed by me and | undertake that, in absence of any document the final admission will not be granted and/or admission will stand cancel Place: Date: i Signature of Student | have permitted my son / daughter / ward to join your college. The information supplied by him / her is correct to the best of my knowledge. Ihave acquainted myself withthe rules and fees, dues to my son/daughter/ward and see that he/she observes. Place: Date: Signature of the Guardian/Parent 114, For College / Institute Use Only Designation Remarks / Particular / Recommendation ‘Signature and Date Admiesion Clerk [Admission Committee Decountent/ easier Registrr/Ofice superintendent ‘Transaction Detals Payment Mode: OFFLINE Cash Receved 0 ‘Transaction 10:NA [REMARK OF THE ADMISSION COMMITTEE Mey be. admitted © toss. Section May be Rejected, Last date of payment of foes. aes ‘Admission may be cancelled if the fees are not paid by this date Principal Signature of Admission Committee Date: