6/20/22, 12:50 PM

For Office Use

Batch: Scrutiny Payment: Online/DD PI

Only Serial:

St. Andrews College of Arts, Science And Commerce. (229)

St. Dominic Road.

Mumbai

Application No :

University of Mumbai 1097934

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

Academic Year: 2022-2023

Regular
APPLICATION FORM

Course Applied for : B.M.S.(with Credits) - Regular - Rev16 - F.Y. B.M.S. Sem I 
(22300005) PRN:
Application Date : 20/06/2022 Payment Category :

1.Personal Information

Candidate's Name(Regional) : दिप

Candidate's Name as printed on Mark WORLIKAR DEEP KISHOR
sheet : [*This name will appear on all University records/documents]

Father's/Husband's Name : KISHOR Mother's Name : MRUNALINI

Marital Status : UnMarried Mother Tongue : Marathi

Place Of Birth : Mumbai Gender : Male Date of Birth (DD/MM/YYYY) : 12/03/2005
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 : Mumbai City Tehsil : Mumbai Location Area : Urban
MUMBAI
Address (House
65/D-A Gonta Lane Worli Village Pin Code : 400030
no,street/area/suburb etc.) :
Permanent Address :
City/Town/Village :
State : Maharashtra District : Mumbai City Tehsil : Mumbai Location Area : Urban
MUMBAI
Address : 65/D-A Gonta Lane Worli Village Pin Code : 400030
Contact details
Mobile Number 9594715430 Email ID: Worlikardeepk@gmail.com
2.Legal Reservation Information
Category Type :
Category : SBC Sub Category : HINDU KOLI
Reserved
Is Guardian from EBC (Economic Backward
Is Specially Abled? No
Class)?  No
3.Social Information(Additional Inforamtion)
Ex-Serviceman/Ward of Ex-Serviceman
Paper Selected for:
Sem I
UBMSFSI.1 - Introduction to Financial Accounts UBMSFSI.2 - Business Law
UBMSFSI.3 - Business Statistics UBMSFSI.5.4 - Foundation Course in Physical Education I
UBMSFSI.4 - Business Communication I UBMSFSI.6 - Foundation of Human Skills
UBMSFSI.7 - Business Economics I
Sem II

UBMSFSII.1 - Principles of Marketing UBMSFSII.2 - Industrial Law

UBMSFSII.3 - Business Mathematics UBMSFSII.5.4 - Foundation Course in Physical Education II
UBMSFSII.4 - Business Communication II UBMSFSII.6 - Business Environment
UBMSFSII.7 - Principles of Management

Medium of Instruction : English

1/2
6/20/22, 12:50 PM
4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 0
5.Educational Details
Month
Name of Name of Board/University and and Exam Certificate Mark
Name of School/College Out of CGPA %
Examination State of University Year of Seat No. No. Obtained
Passing
MAHARASHTRA STATE
BOARD OF SECONDARY AND ADARSH ENGLISH HIGH July
Std 10th A245718 264630 401.00 500.00 --
-
-- 80.20
HIGHER SECONDARY SCHOOL 2020
EDUCATION,Maharashtra
RISHI DAYARAM AND
MAHARASHTRA STATE
SETH HASSARAM
Std 12th BOARD OF SECONDARY AND June
NATIONAL COLLEGE AND M253472 -- 457.00 600.00 --
-
-- 76.17
Commerce HIGHER SECONDARY 2022
SETH WASSIAMULL
EDUCATION,Maharashtra
ASSOMULL SC
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.

Non Creamy Layer Certificate.

Statement of Marks of Std 10th.

Birth Certificate.

Certificate of Caste with Category.

Original Statement of Marks for std. 12th.

Passing Certificate of Std. 12th/Statement of Marks of std.12th.

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 :1097934 (WORLIKAR DEEP KISHOR)
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 Remarks / Particulars / Recommendations Signature and Date
Admission Clerk
Admission
Committee
Accountant/Cashier Cash Received: INR Receipt No.: Date:
Registrar/Office
Superintendent
Document printed on Mon Jun 20 2022 12:50:28 GMT+0530 (India Standard Time)

2/2