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Application No: Regular

This document is an application form for a B.Com course at Birla College of Arts, Science and Commerce. It contains personal information of the applicant such as name, date of birth, address, family details, educational qualifications and declaration. The applicant is applying for admission to the first year of B.Com (Autonomous) program and has provided details of subjects selected as well as required documents. The application is signed by the applicant acknowledging the college rules on ragging and sexual harassment. Spaces are also provided for college remarks and signatures for processing the application.

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71 views

Application No: Regular

This document is an application form for a B.Com course at Birla College of Arts, Science and Commerce. It contains personal information of the applicant such as name, date of birth, address, family details, educational qualifications and declaration. The applicant is applying for admission to the first year of B.Com (Autonomous) program and has provided details of subjects selected as well as required documents. The application is signed by the applicant acknowledging the college rules on ragging and sexual harassment. Spaces are also provided for college remarks and signatures for processing the application.

Uploaded by

Bussiness Empire
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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For Office Use

Batch: Scrutiny Payment: Online/DD PI

Serial:
Only

Birla College of Arts, Science and Commerce (23)

Birla College Road.


Kalyan
Application No :

University of Mumbai
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)

495983

Academic Year: 2022-2023 Regular


APPLICATION FORM

Course Applied for : B.Com. (Autonomous)(with Credits) - Regular - CBCS - F.Y. B.Com.(Autonomous) PRN:
Sem I 
(-)

Application Date : 16/06/2022 Payment Category :


1.Personal Information
Candidate's Name(Regional) : म्हात्रे विशाखा वामन
MHATRE VISHAKHA VAMAN
Candidate's Name as printed on
[*This name will appear on all University

Mark sheet :
records/documents]

Father's/Husband's Name : VAMAN Mother's Name : MANISHA


Marital Status : UnMarried Mother Tongue : Marathi
Place Of Birth : KALYAN Gender : Female Date of Birth (DD/MM/YYYY) : 30/01/2004
Blood Group : Religion : Hindu Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
City/Town/Village :
State : Maharashtra District : Thane Tehsil : Kalyan Location Area : Urban
KALYAN
Address (House
no,street/area/suburb GAURIPADA BEHIND BIRLA COLLEGE MILINDNAGAR KALYAN WEST Pin Code : 421301
etc.) :
Permanent Address :
City/Town/Village :
State : Maharashtra District : Thane Tehsil : Kalyan Location Area : Urban
KALYAN
Address : GAURIPADA BEHIND BIRLA COLLEGE MILINDNAGAR KALYAN WEST Pin Code : 421301
Contact details
Mobile
9224712202 Email ID: [email protected]
Number
2.Legal Reservation Information
Category Type :
Category : OBC Sub Category : AGRI
Reserved
Is Guardian from EBC (Economic
Is Specially Abled? No
Backward Class)?  No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem I
BCOM1001 - Paper 1 BCOM1002 - Paper 2
BCOM1003 - Paper 3 BCOM1004 - Paper 4
Sem II

BCOM2001 - Paper 1 BCOM2002 - Paper 2


BCOM2003 - Paper 3 BCOM2004 - Paper 4

Medium of Instruction : English


4.Guardian Information
Occupation of Guardian : Farmer Annual Income of Guardian : 60000
5.Educational Details
Month
Name of Name of Board/University Name of and Year Exam Certificate Mark Out
CGPA %
Examination and State of University School/College of Seat No. No. Obtained of
Passing
MAHARASHTRA STATE LATE BHAURAO
BOARD OF SECONDARY AND POTE March
Std 10th A066353 098996 447.00 500.00 --
-
-- 89.40
HIGHER SECONDARY VIDYALAYA 2020
EDUCATION,Maharashtra KALYAN
MAHARASHTRA STATE
B K BIRLA
Std 12th BOARD OF SECONDARY AND February
COLLEGE M171842 -- 369.00 600.00 --
-
-- 61.50
Commerce HIGHER SECONDARY 2022
KALYAN WEST
EDUCATION,Maharashtra
Your Last Qualifying Exam: HSC/Std 12th [Commerce]
7.Other Information
Would you like to apply for Hostel accommodation required NA
Required Documents and Certificates Section:
Passing Certificate of Std 12th / Statement of Marks of Std 12th OR Original Passing Certificate /Statement of Marks of Last
Qualifying Exam like degree,diploma,etc.

Certificate of Caste with Category.

Passing Certificate of Std 10th.

Leaving Certificate.

Statement of Marks of Std. 10th.

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
Application No :495983
(MHATRE VISHAKHA VAMAN)
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 )
For College/Institute/Study Center Use Only
Designation Signature and
Remarks / Particulars / Recommendations
Date
Admission Clerk
Admission
Committee
Accountant/Cashier Cash Received: INR Receipt No.: Date:
Registrar/Office
Superintendent
Document printed on Sat Jun 18 2022 15:08:47 GMT+0530 (India Standard Time)

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