Application No: Regular

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For Office Use

Batch: Scrutiny Payment: Online/DD PI

Serial:
Only

G. R. Patil College of Arts, Science and Commerce (727)


Near DNS Bank, Kalyan- Shil Road, Sonarpada. Kalyan Application No :
University of Mumbai 1790602
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
Academic Year: 2023-2024 Regular
APPLICATION FORM

Course Applied for : B.Com.(with Credits) - Regular - Rev16 - F.Y.


PRN:
B.Com. Sem I  (22300001)

Application Date : 21/06/2023 Payment Category :


1.Personal Information
Candidate's Name(Regional) : अभिषेक बिबिषण पवार
Candidate's Name as printed PAWAR ABHISHEK BIBISHAN
on Mark sheet : [*This name will appear on all University records/documents]
Mother's
Father's/Husband's Name : BIBISHAN JAISHI
Name :
Mother
Marital Status : UnMarried Marathi
Tongue :
Place Of Birth : Sundarwadi Gender : Male Date of Birth (DD/MM/YYYY) : 23/09/2005
Blood Group : Religion : Hindu Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
City/Town/Village : Location Area :
State : Maharashtra District : Thane Tehsil : Kalyan
Dombivali Semiurban
Address (House
no,street/area/suburb Room No. 103 Kalyan Shil Road Pin Code : 421204
etc.) :
Permanent Address :
City/Town/Village : Location Area :
State : Maharashtra District : Thane Tehsil : Kalyan
Dombivali Semiurban
Address : Room No. 103 Kalyan Shil Road Pin Code : 421204
Contact details
Mobile
8097153367 Email ID: shubhambangar569@gmail.com
Number
2.Legal Reservation Information
Category Type :
Category : GEN
Open
Is Guardian from EBC (Economic
Is Specially Abled? No
Backward Class)?  No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem I
UBCOMFSI.1 - Accountancy and Financial Management I UBCOMFSI.2 - Commerce I
UBCOMFSI.3 - Business Economics I UBCOMFSI.4 - Business Communication I
UBCOMFSI.5 - Environmental Studies I UBCOMFSI.7 - Mathematical and Statistical Techniques I
UBCOMFSI.6.1 - Foundation Course I
Sem II

UBCOMFSII.1 - Accountancy and Financial Management II UBCOMFSII.2 - Commerce II


UBCOMFSII.3 - Business Economics II UBCOMFSII.4 - Business Communication II
UBCOMFSII.5 - Environmental Studies II UBCOMFSII.7 - Mathematical and Statistical Techniques II
UBCOMFSII.6.1 - Foundation Course II

Medium of Instruction : English


4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 89000
5.Educational Details
Month
Name of Name of Board/University Name of and Exam Certificate Mark Out
CGPA %
Examination and State of University School/College Year of Seat No. No. Obtained of
Passing
MAHARASHTRA STATE
BOARD OF SECONDARY AND CHANAGULE June
Std 10th A047735 S214101153 328.00 500.00 -- - -- 65.60
HIGHER SECONDARY VIDYALAYA 2021
EDUCATION,Maharashtra
MAHARASHTRA STATE
Std 12th BOARD OF SECONDARY AND May
KR KOTKAR M179568 H1234072671 407.00 600.00 -- - -- 67.83
Commerce HIGHER SECONDARY 2023
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.

Passing Certificate of Std 10th.

Leaving Certificate.

Birth Certificate.

Father’s Income certificate from Tahsildar.

Passing Certificate of Std. 10th.

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

School/College 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 :1790602
(PAWAR ABHISHEK BIBISHAN) 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 Mon Aug 07 2023 11:23:54 GMT+0530 (India Standard Time)

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