For Office Use
Batch: Scrutiny Payment: Online/DD PI
Only Serial:
Rayat Shikshan Sansthas Mahatma Phule Arts, Science and Commerce College (487)
Application No :
University of Mumbai 300058
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
Academic Year: 2024-2025
Regular
APPLICATION FORM
Course Applied for : B.Sc. (I.T.)(with Credits) - Regular - Rev16 - S.Y. PRN:2023016400269421
B.Sc. (I.T.) Sem III (42300003)
Application Date : 08/08/2024 Payment Category : 25
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed DHAYGUDE PIYUSH NANA
on Mark sheet : [*This name will appear on all University records/documents]
Mother's
Father's/Husband's Name : NANA JAYSHREE
Name :
Mother
Marital Status : UnMarried
Tongue :
Place Of Birth : Mumbai Gender : Male Date of Birth (DD/MM/YYYY) : 04/09/2005
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 : Panvel City/Town/Village :
Available
Address (House
no,street/area/suburb Sadguru Planet Room No 505 Sec-2E Plot No-6A Pin Code : 410218
etc.) :
Contact details
Mobile
917039906870 Email ID:
[email protected]Number
2.Legal Reservation Information
Category Type : Category : NT-2
Reserved (NT-C)
Is Guardian from EBC (Economic
Is Specially Abled? No
Backward Class)? No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem III
USIT301 - Python Programming. USIT302 - Data Structures
USIT303 - Computer Networks USIT304R - Operating Systems
USIT305 - Applied Mathematics USIT3P1 - Python Programming Practical
USIT3P2 - Data Structures Practical USIT3P3 - Computer Networks Practical
USIT3P4R - Operating Systems Practical USIT3P5 - Mobile Programming Practical
Sem IV
USIT401 - Core Java USIT402 - Introduction to Embedded Systems
USIT403 - Computer Oriented Statistical Techniques USIT404 - Software Engineering
USIT405 - Computer Graphics and Animation USIT4P1 - Core Java Practical
USIT4P2 - Introduction to Embedded Systems Practical USIT4P3 - Computer Oriented Statistical Techniques
USIT4P4 - Software Engineering Practical Practical
USIT4P5 - Computer Graphics and Animation Practical
Medium of Instruction : English
4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 0
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 -- -- 357.00 500.00 -- - -- 71.40
AND HIGHER SECONDARY
EDUCATION,
MAHARASHTRA STATE
Std 12th 12Th BOARD OF SECONDARY
May 2023 -- -- 336.00 600.00 -- - -- 56.00
(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 Thu Aug 08 2024 16:13:02 GMT+0530 (India Standard Time)
