APPLICATION NO : CVM2023/2722

Personal Details
Programme Details
Programme
Faculty FACULTY OF SCIENCE Course UG NVPAS - B.C.A.
Preference 1
Programme Programme
Programme Preference 2
Preference 3 Preference 4
Programme Programme
Programme Preference 5
Preference 6 Preference 7
Programme Programme
Programme Preference 8
Preference 9 Preference 10
Student’s Personal Details
Title MR First Name TIRTHKUMAR Middle Name HITESHBHAI
Name As Per Last
PATEL TIRTHKUMAR Student’s Mobile
Last Name PATEL Qualifying +91-9624582008
HITESHBHAI Number
Marksheet
HITESHRPATEL8170@GMA
Student’s Email ID Date Of Birth 09/06/2006 Gender MALE
IL.COM
Blood Group B+ Nationality INDIAN Category GENERAL
Student’s Aadhaar Card Student's Name as PATEL TIRTHKUMAR
292334134809 Students ABC Id? 579014253972
No per Aadhaar Card HITESHBHAI
Are You differently
abled?
Parent's Details
PATEL HITESHBHAI
Father's Name Father's Mobile No +91-9624582009 Father's Email ID
RATILAL
PATEL HANSABEN Mother's Mobile
Mother's Name Mother's Email ID
HITESHBHAI No.
Address Details
Correspondence Address
Country INDIA State GUJARAT District AHMEDABAD
26, PATEL VAS,
Address Line 1 RAKHIYANA, MANDAL, Address Line 1 Pincode 382130
AHMEDABAD
Is permanent address
same as address for YES
correspondence?
Permanent Address
Country INDIA State GUJARAT District AHMEDABAD
26, PATEL VAS,
Address Line 1 RAKHIYANA, MANDAL, Address Line 1 Pincode 382130
AHMEDABAD
Educational Details
Educational Details
10th School
10th School State GUJARAT MEHSANA 10th School Taluka KADI
District

10th/SSC Details
Board/University School Name Year of Passing Marking Scheme Percentage/CGPA
GUJARAT SECONDARY
P.M.G THAKAR
AND HIGHER
10th/SSC ADARSH 2021 PERCENTAGE 75
SECONDARY
HIGHSCHOOL
EDUCATION BOARD

After 10th/SSC 12th School

12TH/HSC 12th School State GUJARAT AHMEDABAD
Qualification District
12th School Taluka MANDAL

12th/SSC Details
Theory
Year Of Marking
Board/University School Name Major Subject Result Status Subject Percentage/CGPA
Passing Scheme
Percentile
KUVARBEN
GUJARAT SECONDARY AND
ISVARBHAI
12th/HSC HIGHER SECONDARY EDUCATION COMMERCE 2023 DECLARED PERCENTAGE 80
MEGHMANI
BOARD
HIGHSCHOOL

Diploma State Diploma District Diploma Taluka

Diploma Details
Board/University Institute Name Major Subject Year Of Passing Marking Scheme Percentage/CGPA
Diploma

Graduation Details
Degree Specialization/Discipline Result Status Marking Scheme Percentage/CGPA
UG

Graduation Graduation
Graduation State
University Institute

Post Graduation Details

Degree Specialization/Discipline Result Status Marking Scheme Percentage/CGPA
PG

Post Graduation Post Graduation Post Graduation

State University Institute

Entrance Test Details

Have you appeared for any entrance
test(Yes/No)?

Entrance Test Details

Name of the Test Year of Passing Percentile/Score
1
2
3

Entrance Test Details

JEE(MAIN)
registration NTA Score
number
ACPC Details
Have you
ACPC registration
appeared through ACPC Merit Marks
number
ACPC?
ACPC Rank
Upload Documents
Upload Documents

Upload Aadhaar Upload Your Photo Upload 10th

YES YES
Card : : Marksheet :

Upload
Upload 12th Upload Diploma
YES NO Graduation NO
Marksheet : Marksheet :
Marksheet :
Upload Post
Upload GUJCET Upload NATA
Graduation NO NO NO
Scorecard : Scorecard :
Marksheet :
Upload JEE/JEE- Upload CAT Upload CMAT
NO NO NO
Mains Scorecard : Scorecard : Scorecard :
Upload NEET Upload Leaving Upload caste
NO YES NO
Scorecard : Certificate : certificate :
Upload
Provisional
NO
Eligibility
Certificate (PEC) :

Declaration
1.I, HEREBY, DECLARE THAT, THE DETAILS GIVEN BY ME IN THE ADMISSION FORM ARE COMPLETE AND TRUE TO THE BEST OF MY
KNOWLEDGE AND BASED ON RECORDS.
2.I, HEREBY, UNDERTAKE TO PRESENT THE ORIGINAL DOCUMENTS IMMEDIATELY UPON DEMAND BY THE CONCERNED AUTHORITIES OF THE
CVM UNIVERSITY.
3.I, HEREBY, PROMISE TO ABIDE BY THE ADMISSIBLE RULES AND REGULATIONS, CONCERNING DISCIPLINE, ATTENDANCE, ETC. OF CVM
UNIVERSITY, AND ALSO TO FOLLOW THE CODE OF CONDUCT PRESCRIBED FOR THE STUDENTS OF THE CVM UNIVERSITY, AS IN FORCE FROM
TIME TO TIME AND SUBSEQUENT CHANGES/MODIFICATIONS/AMENDMENT MADE THERETO. I ACKNOWLEDGE THAT, THE CVM UNIVERSITY HAS
THE AUTHORITY FOR TAKING PUNITIVE ACTIONS AGAINST ME FOR VIOLATION AND/OR NON-COMPLIANCE OF THE SAME.
4.I UNDERSTAND THAT, 75% ATTENDANCE IN CLASSES IS COMPULSORY AND I COMMIT MYSELF TO ADHERE TO THE SAME. I ALSO
UNDERSTAND, IN CASE MY ATTENDANCE FALLS SHORT, FOR ANY REASON, THE COMPETENT AUTHORITY OF THE INSTITUTE MAY TAKE SUCH
PUNITIVE ACTIONS AGAINST ME, AS MAY BE DEEMED FIT AND PROPER.
5.I, HEREBY DECLARE THAT, I WILL NEITHER JOIN IN ANY COERCIVE AGITATION/STRIKE FOR THE PURPOSE OFF FORCING THE AUTHORITIES OF
THE CVM UNIVERSITY TO SOLVE ANY PROBLEM, NOR I WILL PARTICIPATE IN ACTIVITY WHICH HAS A TENDENCY TO DISTURB THE PEACE AND
TRANQUILITY OF LIFE OF THE CVM UNIVERSITY CAMPUS AND/OR ITS HOSTEL PREMISES.
6.I, HEREBY DECLARE THAT, I WILL NOT INDULGE IN, NOR TOLERATE RAGGING, IN ANY FORM, EVEN IN WORDS OR INTENTIONS, AND I
ACCEPT TO GIVE AN UNDERTAKING IN THE PRESCRIBED FORMAT FOR THE SAME. I, HEREBY DECLARE THAT, I SHALL BE SOLELY RESPONSIBLE
FOR MY INVOLVEMENT IN ANY KIND OF UNDESIRABLE/DISCIPLINARY ACTIVITIES OUT SIDE THE CAMPUS, AND SHALL BE LIABLE FOR
PUNISHMENT AS PER UNIVERSITY. I, FURTHER UNDERSTAND THAT, THE INSTITUTE SHALL IN NO WAY PROVIDE ANY SUPPORT TO ME AND
WILL NOT BE HELD RESPONSIBLE FOR MY ANY SUCH ACTION.
7.I, ALSO DECLARE THAT, I AM NOT SUFFERING FROM ANY SERIOUS/CONTAGIOUS AILMENT AND/OR ANY PSYCHIATRIC/PSYCHOLOGICAL
DISORDER.
8.I, FURTHER DECLARE THAT, MY ADMISSION MAY BE CANCELLED, AT ANY STAGE, IF I AM FOUND INELIGIBLE AND/OR THE INFORMATION
PROVIDED BY ME ARE FOUND TO BE INCORRECT. 9.I, HEREBY UNDERTAKE TO INFORM THE CVM UNIVERSITY , ABOUT ANY CHANGES IN
INFORMATION SUBMITTED BY ME, IN THE ADMISSION FORM AND ANY OTHER DOCUMENTS, INCLUDING CHANGE IN ADDRESSES AND
CONTACT NUMBER, FROM TIME TO TIME.
10.I, HEREBY DECLARE THAT, IN CASE I CANCEL MY ADMISSION DURING ANYTIME OF COURSE, I WILL FOLLOW ALL THE RULES AND
REGULATIONS OF THE UNIVERSITY
Paren
PATEL TIRTHKUMAR PATEL HITESHBHAI
Applicant Name t Date 26/06/2023
HITESHBHAI RATILAL
Name
place AHMEDABAD
For office use only
Tuition Fees
Date:
Received
Provisional
Final Admission
Admission
Accountant
Director/Principal Signature
Signature