G. E.

Society's
ARTS, COMMERCE & SCIENCE JUNIOR COLLEGE, NASHIK ROAD
UDISE PLUS DATA FORM (AY-2022-23)
Sr. No. Particular Response
4.1.1 Student's Name in CAPITAL
1
LETTERS (Start with First Name)
2 4.1.2 Gender 1-Male 2-Female 3-Transgender

3 4.1.3 Date of Birth (DD/MM/YYYY)

4 4.1.4 Mother's Name (IN CAPITAL)

5 4.1.5 Father's Name (IN CAPITAL)

6 4.1.6 Guardian's Name (IN CAPITAL)

7 4.1.7 Aadhaar Number of Student

4.1.8 Name of Student as per Aadhaar
8
Card (IN CAPITAL)
9 4.1.9 (a) Address

10 4.1.9 (b) Pincode

4.1.10 (a) Mobile Number (of
11
Student/ Parent/ Guardian)
4.1.10 (b) Alternate Mobile Number
12
(of Student/ Parent/ Guardian)
4.1.11 Contact email-id (of
13
Student/Parent/Guardian)
42-Hindi 106-Marathi 00-Other
14 4.1.12 Mother Tongue of the Student
(00-if Other Mention Mother Tongue) ____________________
1- GENERAL 2-SC 3-ST 4-OBC 5-NT B 6-NT C 7-NT D 8-SBC
15 4.1.13 Social Category
9-SEBC 10-VJA ________________
1-Muslim 2-Christian 3-Sikh 4-Buddhist 5-Parsi 6-Jain 7-NA
16 4.1.14 Minority Group
________________
17 4.1.15 Whether BPL beneficiary? Yes / No
4.1.16 Whether belongs to EWS /
18 Yes / No
Disadvantaged Group?
19 4.1.17 Whether CWSN? Yes / No
4.1.17 (a) If Yes, (a) Type of
20 __________________________________
impairment
4.2.2 Admission Date (DD/ MM/ YYYY)
21 in Present Class (Enter date from
Admission Fee Reciept)
XI ARTS XI COMMERCE XI SCIENCE
22 Class
XII ARTS XII COMMERCE XII SCIENCE
23 Roll Number __________________________________

Page 1 of 2
 G. E. Society's
ARTS, COMMERCE & SCIENCE JUNIOR COLLEGE, NASHIK ROAD
UDISE PLUS DATA FORM (AY-2022-23)
Sr. No. Particular Response
4.2.6 (c) Percentage (%) obtained in
24
class 10th
4.2.6 (c) Percentage (%) obtained in
25
class 11th (If Applicable)
4.3.1 (b) Scholarship Received by
26
Student (in Class 11th If Applicable)

Parents Signature Students Signature

Attached Documents
1) Photocopy of Class 10th Marksheet
2) Photocopy of Class 10th Leaving Certificate
3) Photocopy of Class 11th Marksheet (Only for Class 12th Student)
4) Photocopy of Certificate of Physical Disability
5) Photocopy of Ration Card (Yellow) or BPL Certificate (If student belongs to BPL Category)
6) Photocopy of Aadhar Card
7) Photocopy of Cast Certificate
8) Photocopy of EWS Certificate
9) Photocopy of Admission Fee Reciept

Page 2 of 2