UNIVERSITY OF MUMBAI

INSTITUTE OF DISTANCE EDUCATION

(Application for change of Name /Address /Subject)

From: Date:
Name of the Student
Shri/Smt./Kum. _________________________________________________________________________
(In Block Letters) (Surname) (Own Name) (Father’s/Husband’s Name) (Mother’s Name)
Residential Address (As registered in the IDE record)
______________________________________________________________________________________
______________________________________________________________________________________
Pin Code: ____________ Tel No. __________________________________________________________
Class ________________ Year 2008 to 2009. Roll No. ______________________
Fee Receipt No. ________________
Date: _________________________
To,
The Professor-cum- Director,

Sir,

I have taken admission to the _______________________________ Course.

My new Name/Address/Subject is as under. Kindly change the same accordingly

_________________________________ ________________________________
_________________________________ ________________________________
_________________________________ ________________________________

Thanking you ,
Yours faithfully,

Signature of the student

N.B:1. As documentary proof, I am submitting the Original with two attested Xerox copies of the Gazette
Notification of the Government and / or the Marriage Certificate for change in Name/Original
Address Proof for Change of Residence. I request you to kindly make the necessary change in my
name/Address/Subject in your office records.
2. Attach Ration Card/Election Card /Telephone Bill/Electricity etc.
3. Students desirous of changing the subject once offered can do so before 31st October of the
Academic year. Student admitted after 30St September if any, will not be allowed to change any
Subjects.
______________________________________________________________________________

(FOR OFFICE USE ONLY)

Permitted to change the Subject Name/Address/Subjects. Yes No

Signature of the Concerned Clerk Signature of the Asstt. Registrar (Admn)

 mauMba[- ivaVapIz
dUr iSaxaNa saMsqaa
(naava / Pa<ta / ivaYaya badlauna GaoNyaasaazI Aja-)

p`oYak : idnaMak : __________

ivaVaqyaM-Macao naava : EaI/EaImatI/kumaarI: _________________________________________
(AaDnaava) (svat:cao naava) (vaiDlMaacao/PatIcao naava) (Aa[-cao naava)

saMsqaocyaa dFtrI naaoMd Asalaolaa p<ta : _________________________________________

_____________________________________________________________
ipna kaoD :________________durQvanaI Ë`maak : ___________________
vaga- : _____________SaOxaiNak vaYa- 2008-09 pT Ë`maak :_____________

p`it,
maa.p`aQyapk AaiNa saMcaalak,
mahaodya,
maI _________________ yaa AByaasaË`masaazI Pa`vaoSa Gaotlaolaa Aaho.
kRpyaa maaJao naivana naava / Pa<ta / ivaYayaKalaIla p`maaNao Aaho, yaamaQyao yaaogya tao badla kravaa.
________________________ _______________________
________________________ _______________________
________________________ _______________________

Qanyavaad, Aaplaa ivaSvaasaU

ivaQyaaqya-acaI svaaxarI
ivaSaoYa saucanaa:
1. puravyaadaKla maI SaasakIya rajap~/ ivavaahacaa maul daKlaa va <yaacyaa daona saaxaMakIt p`tI yaa saaobat
jaaoDt Aaho. %yaMacaI CananaI kÉna %yaamaQyao yaaogya tao badla kravaa.
2. iSaQaapi~ka/inavaDNaUk AaoLKp~/durQvanaI/vaIja baIla ikMvaa [tr puravaa.
3. caalaU SaOxaiNak vaYaa-t 31 Aa^@Taobar\ Pa\UvaI-- ivaVaqya-anaa ivaYaya badlaNyaacaI saMGaI idlaI jaa[-la.
31 Aa^@Taobar\ naMtr jar eKadyaa ivaVaqya-alaa Pa`vaoSa idlaa gaolaa Asaola, %yaalaa ivaYaya badlaNyaasa
prvaanagaI idlaI jaaNaar naahI.
__________________________________________________________
( kayaa-layaIna kamakajaasaazI )
naava / Pa<ta / ivaYaya badlaUna doNyaasa prvaanagaI Aaho / naahI
sMabMaiQat karkunaacaI sahI sahayyak kulasaicavaacaI sahI

idnaMak :