20/06/2022, 20:33

For Office Use

Batch: Scrutiny Payment: Online/DD PI

Only Serial:

R. D. National College of Arts and Commerce and W. A. Science College (163)

Linking Road, 32 ND Tps III, Opp. Barista.

Mumbai
Application No :

University of Mumbai 1184997

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

Academic Year: 2022-2023

Regular
APPLICATION FORM

Course Applied for : B.Sc. (I.T.)(with Credits) - Regular - Rev16 - F.Y. B.Sc. (I.T.) Sem I 
(42300003) PRN:
Application Date : 20/06/2022 Payment Category :
1.Personal Information

Candidate's Name(Regional) : सिंहा जयप्रकाश प्रभात

Candidate's Name as printed on Mark SINGHA JAYPRAKASH PRABHAT
sheet : [*This name will appear on all University records/documents]

Father's/Husband's Name : PRABHAT Mother's Name : JAYANTI

Marital Status : UnMarried Mother Tongue : Oriya

Place Of Birth : Gender : Male Date of Birth (DD/MM/YYYY) : 03/03/2005
Blood Group : ABPositive 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
Santacruz
Address (House
Laundy Gali Gazadhar Bandh Govind Nagar Mumbai Pin Code : 400054
no,street/area/suburb etc.) :
Permanent Address :
City/Town/Village :
State : Maharashtra District : Mumbai City Tehsil : Mumbai Location Area : Urban
Santacruz
Address : Laundy Gali Gazadhar Bandh Govind Nagar Mumbai Pin Code : 400054
Contact details
Mobile Number 9029440549 Email ID: jayprakash.psingha@gmail.com
2.Legal Reservation Information
Category Type : Open Category : GEN
Is Guardian from EBC (Economic Backward
Is Specially Abled? No
Class)?  No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:

Sem I
USIT101 - Imperative Programming USIT102 - Digital Electronics
USIT103 - Operating Systems USIT104 - Discrete Mathematics
USIT105 - Communications Skills USIT1P1 - Imperative Programming Practical
USIT1P2 - Digital Electronics Practical USIT1P3 - Operating Systeams Practical
USIT1P4 - Discrete Mathematics Practical USIT1P5 - Communications Skills Practical
Sem II

USIT201 - Object oriented programming USIT202 - Microprocessor Architecture

USIT203 - Web Programming USIT204 - Numerical and Statistical Methods
USIT205 - Green Computing USIT2P1 - Object Oriented Programming Practical
USIT2P2 - Microprocessor Architecture Practical USIT2P3 - Web Programming Practical
USIT2P4 - Numerical and Statistical Methods Practical USIT2P5 - Green Computing Practical

Medium of Instruction : English

4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 100000
5.Educational Details

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Month
Name of Name of Board/University and State of Name of Exam Certificate Mark
and Year Out of CGPA %
Examination University School/College Seat No. No. Obtained
of Passing
MAHARASHTRA STATE BOARD OF GURU
August
Std 10th SECONDARY AND HIGHER HARIKRISHNA A278665 -- 337.00 500.00 --
-
-- 67.40
2020
SECONDARY EDUCATION,Maharashtra HIGH SCHOOL
MAHARASHTRA STATE BOARD OF
Std 12th R.D NATIONAL
SECONDARY AND HIGHER June 2022 M068209 -- 318.00 600.00 --
-
-- 53.00
Science COLLEGE
SECONDARY EDUCATION,Maharashtra
Your Last Qualifying Exam: HSC/Std 12th [Science]
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.

Passing Certificate of Std 10th.

Leaving Certificate.

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 :1184997 (SINGHA JAYPRAKASH PRABHAT)
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 20:33:12 GMT+0530 (India Standard Time)

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