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Rayat Shikshan Sansthas Karmveer Bhaurao Patil College (Modern College) (301)
Application No :
University of Mumbai
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
143662
Academic Year: 2024-2025 Regular
APPLICATION FORM
Course Applied for : B.M.S.(Autonomous)(with Credits) - Regular - PRN:2022016401580734
CBCS - T.Y. B.M.S.(Autonomous) Sem V (-)
Application Date : 24/07/2024 Payment Category : 13
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed PARTHE TEJAS TANAJI
on Mark sheet : [*This name will appear on all University records/documents]
Mother's
Father's/Husband's Name : TANAJI ANJANA
Name :
Mother
Marital Status : UnMarried
Tongue :
Place Of Birth : PUNE Gender : Male Date of Birth (DD/MM/YYYY) : 22/11/2003
Blood Group : Religion : Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
District : Mumbai Location Area : Not
State : Maharashtra Tehsil : Kurla City/Town/Village :
Suburban Available
Address (House
no,street/area/suburb SHIV KRIUPA MAHARASHTRA NAGAR MANKHURD Pin Code : 400088
etc.) :
Contact details
Mobile
919356832501 Email ID:
[email protected]Number
2.Legal Reservation Information
Category Type :
Category : GEN
Open
Is Guardian from EBC (Economic
Is Specially Abled? No
Backward Class)? No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem V
BMS001 - PAPER I BMS002 - PAPER II
BMS003 - PAPER III BMS004 - PAPER IV
Sem VI
BMS005 - PAPER V BMS006 - PAPER VI
BMS007 - PAPER VII BMS008 - PAPER VIII
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 March
Std 10th -- -- 401.00 500.00 -- - -- 80.20
AND HIGHER SECONDARY 2020
EDUCATION,
MAHARASHTRA STATE
Std 12th 12Th BOARD OF SECONDARY March
-- -- 390.00 600.00 -- - -- 65.00
(Commerce) AND HIGHER SECONDARY 2022
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 Wed Jul 24 2024 09:43:27 GMT+0530 (India Standard Time)
