1/31/24, 11:49 AM about:blank
For Office Use
Batch: Scrutiny Payment: Online/DD PI
Only Serial:
South Indian Education Society`s Graduate School of Technology (690)
Application No :
University of Mumbai 3078171
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
Academic Year: 2023-2024
Regular
APPLICATION FORM
Course Applied for : B.E.(with Credits) - Regular - CBCS - Artificial Intelligence PRN:2022016402077885
and Machine Learning - S.E. C-Scheme Sem III (BECBCS1001)
Application Date : 31/01/2024 Payment Category : 25
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed on THAKUR VEDANT JITENDRA
Mark sheet : [*This name will appear on all University records/documents]
Father's/Husband's Name : JITENDRA Mother's Name : JANHAVI
Marital Status : UnMarried Mother Tongue :
Place Of Birth : Uran Gender : Male Date of Birth (DD/MM/YYYY) : 16/06/2004
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 : Thane Tehsil : Thane City/Town/Village :
Available
Address (House
Al-3-36/11/Godavari Chs/Sector-19/Airoli Navi Mumbai Pin Code : 400708
no,street/area/suburb etc.) :
Contact details
Mobile Number 919930946444 Email ID:
[email protected] 2.Legal Reservation Information
Category Type :
Category : OBC
Reserved
Is Guardian from EBC (Economic Backward
Is Specially Abled? No
Class)? No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem III
AIDSCSAC301 - Engineering Mathematics-III AIDSCSCA302 - Discrete Structures and Graph Theory
AIDSCSCA303 - Data Structure AIDSCSCA304 - Digital Logic and Computer Architecture
AIDSCSCA305 - Computer Graphics AIDSCSLA301 - Data Structure Lab
AIDSCSLA302 - Digital Logic and Computer Architecture Lab AIDSCSLA303 - Computer Graphics Lab
AIDSCSLA304 - Skill base Lab course: Object Oriented Programming AIDSCSMA301 - Mini Project – 1 A
with Java
Sem IV
AIDSCSCA401 - Engineering Mathematics - IV AIDSCSCA402 - Analysis of Algorithm
AIDSCSCA403 - Database Management System AIDSCSCA404 - Operating System
AIDSCSCA405 - Microprocessor AIDSCSLA401 - Analysis of Algorithm Lab
AIDSCSLA402 - Database Management System Lab AIDSCSLA403 - Operating System Lab
AIDSCSLA404 - Microprocessor Lab AIDSCSLA405 - Skill Base Lab Course: Python Programming
AIDSCSMA401 - Mini Project 1-B
Medium of Instruction : English
4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 0
5.Educational Details
about:blank 1/2
1/31/24, 11:49 AM about:blank
Month and Exam
Name of Name of Board/University and State Name of Certificate Mark
Year of Seat Out of CGPA %
Examination of University School/College No. Obtained
Passing No.
CENTRAL BOARD OF SECONDARY
Std 10th July 2020 -- -- 393.00 500.00 -- - -- 78.60
EDUCATION,
MAHARASHTRA STATE BOARD OF
Std 12th 12Th
SECONDARY AND HIGHER March 2022 -- -- 347.00 600.00 -- - -- 57.83
(Science)
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 Wed Jan 31 2024 11:49:52 GMT+0530 (India Standard Time)
about:blank 2/2
