For Office Use

Batch: Scrutiny Payment: Online/DD PI

Serial:
Only

Bharati Vidyapeeth College Of Engineering (17)

Application No :
University of Mumbai
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
3056553
Academic Year: 2023-2024 Regular
APPLICATION FORM

Course Applied for : B.E.(with Credits) - Regular - CBCS - Electronics

and Telecommunication Engineering - B.E. C-Scheme Sem VII PRN:2020016401946972
(BECBCS1001)

Application Date : 19/12/2023 Payment Category : 13

1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed DUBAL ARYAN RAJANI
on Mark sheet : [*This name will appear on all University records/documents]
Mother's
Father's/Husband's Name : RAJAN RAJANI
Name :
Mother
Marital Status : UnMarried
Tongue :
Place Of Birth : Gender : Male Date of Birth (DD/MM/YYYY) : 25/06/2002
Blood Group : Religion : Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Thane Tehsil : Kalyan City/Town/Village :
Available
Address (House
no,street/area/suburb Prithviraj Appartment Room No. 405 Tisgaon Kalyan Pin Code : 421306
etc.) :
Contact details
Mobile
918425878489 Email ID: aryanrv12@gmail.com
Number
2.Legal Reservation Information
Category Type :
Category : SC
Reserved
Is Guardian from EBC (Economic
Is Specially Abled? No
Backward Class)? No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem VII
42471 - Microwave Engineering 42472 - Mobile Communication System
ECL701 - Microwave Engineering Laboratory ECL702 - Mobile Communication System Laboratory
ECP701 - Major Project-I 42475 - Cloud Computing and Security
42479 - 5G Technology 42488 - Cyber Security and Laws
Sem VIII

52971 - Optical Communication and Networks ECL801 - Optical Communication and Networks Laboratory
ECP801 - Major Project-II 52974 - Wireless Networks
52979 - Network Management in Telecommunication 52989 - Digital Business Management

Medium of Instruction : English

4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 353030
5.Educational Details
Month and Exam
Name of Name of Board/University and Name of Certificate Mark Out
Year of Seat CGPA %
Examination State of University School/College No. Obtained of
Passing No.
MAHARASHTRA STATE BOARD
March
Std 10th OF SECONDARY AND HIGHER -- -- 431.00 500.00 -- - -- 86.20
2018
SECONDARY EDUCATION,
MAHARASHTRA STATE BOARD
Std 12th 12Th February
OF SECONDARY AND HIGHER -- -- 404.00 650.00 -- - -- 62.15
(Science) 2020
SECONDARY EDUCATION,
Your Last Qualifying Exam:
7.Other Information
Would you like to apply for Hostel accommodation required NA
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 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 )
Document printed on Tue Dec 19 2023 16:21:28 GMT+0530 (India Standard Time)