11/25/2020

For Office Use

Batch: Scrutiny Payment: Online/DD PI

Only Serial:

Parle Tilak Vidyalaya Associations Sathaye College (155)

Application No :
University of Mumbai 3398148
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
Academic Year: 2020-2021
Regular
APPLICATION FORM

Course Applied for : M.Sc.(with Credits) - Regular - CBCS - Information Technology - M.Sc. Part II Sem III (-) PRN:2016016401723215
Application Date : 25/11/2020 Payment Category : 45

1.Personal Information

Candidate's Name(Regional) :
Candidate's Name as printed on Mark BHADEKAR SHUBHAM VILAS
sheet : [*This name will appear on all University records/documents]
Father's/Husband's Name : VILAS BHADEKAR Mother's Name : VAISHALI

Marital Status : UnMarried Mother Tongue :

Place Of Birth : MUMBAI Gender : Male Date of Birth (DD/MM/YYYY) : 12/04/1999
Blood Group : Religion : Country of Citizenship : India
Height : Not Available Weight : Not Available Hemoglobin : Not Available
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Mumbai Suburban Tehsil : Andheri City/Town/Village :
Available
Address (House
JACK D MELLO CHAWL ROOM NO 8 ANDHERI AMBOLI WEST Pin Code : 400058
no,street/area/suburb etc.) :
Contact details
Mobile Number 918433514772 Email ID: [email protected]
2.Legal Reservation Information
Category Type :
Category : OBC
Reserved
Is Specially Abled? No
3.Social Information(Additional Inforamtion)

Paper Selected for:

Sem III
PSIT301 - Technical Writing and Entrepreneurship Development PSIT3P1 - Project Documentation and Viva
PSIT302a - Applied Artificial Intelligence PSIT3P2a - Applied Artificial Intelligence Practical
PSIT303a - Machine Learning PSIT3P3a - Machine Learning Practical
PSIT304a - Robotic Process Automation PSIT3P4a - Robotic Process Automation Practical
Sem IV

PSIT401 - Blockchain PSIT4P1 - Blockchain Practical

PSIT4P4 - Project Implementation and Viva PSIT402a - Natural Language Processing
PSIT4P2a - Natural Language Processing Practical PSIT403a - Deep Learning
PSIT4P3a - Deep Learning Practical PSIT404a - Human Computer Interaction

Medium of Instruction : English

4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 120221
5.Educational Details

1/2
11/25/2020

Month and Exam

Name of Name of Board/University and State of Name of Certificate Mark
Year of Seat Out of CGPA %
Examination University School/College No. Obtained
Passing No.
MAHARASHTRA STATE BOARD OF
Std 10th SECONDARY AND HIGHER March 2014 -- -- 413.00 500.00 -- - -- 82.60
SECONDARY EDUCATION,
MAHARASHTRA STATE BOARD OF
Std 12th 12Th February
SECONDARY AND HIGHER -- -- 340.00 650.00 -- - -- 52.31
(Science) 2016
SECONDARY EDUCATION,
Degree : B.Sc. (I.T.)
(With Credits)- Passed -- -- - - -- - -- -
Regular-Rev16
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 Nov 25 2020 11:07:41 GMT+0530 (India Standard Time)

2/2