Application Form July 2024 Session

Application Number : BVDU/SDE/JUL24/00943

Programme Details
List of Center Y.M.I.M KARAD Program UG
Course B.A. - BACHELOR OF ARTS Mode of Studies Distance

Personal Details
Title MR. First Name SHIKALGAR
SHAHRUKHSHIKALGAR46@GMAIL.CO
Surname RAMJAN Email Address
M
Alternate Email ID PAKIJASHIKALGAR123@GMAIL.COM Mobile Number +91-7038591777
Alternate Mobile Number +91-8669128705 Gender MALE
Date of Birth 30/06/1997 Age as on 31 March 2024 26 YEARS , 9 MONTHS , 1 DAY
Marital Status MARRIED Area RURAL
Minority NO Minority Details
Economically Weaker
Person with Disability NO NO
Section
Nationality INDIAN Aadhaar Card Number 847471593166
ABC ID (Academic Bank
Category OTHER|NT(B)
Credits)
Digilocker ID Passport Number
Passport Valid Upto

Parent Details
Father's Name RAMJAN BABALAL SHIKALGAR Father's Mobile +91-9767857995
Mother's Name SHAINAJ RAMJAN SHIKALGAR Mother's Mobile +91-7666051752
Guardian's Name JISHAN RAMJAN SHIKALGAR Guardian's Mobile +91-7620344537

Address Details
Address For Correspondence Permanent Address
Country INDIA INDIA
State MAHARASHTRA MAHARASHTRA
District SATARA SATARA
City KARAD KARAD
Address Line 1 KODOLI KARAD KODOLI KARAD
Address Line 2 KODOLI KODOLI
Pincode 415124 415124

Other Details
Are you an existing employee of Bharati Vidyapeeth (Deemed to be University)? NO
BV(DU) All Constituent BV(DU) All Constituent unit
Units List code (Internal Use)
Designation Period - From
Period - To No. of years
Gross Annual Income
Are you an Existing student / Alumni of Bharati Vidyapeeth (Deemed to be
NO
University)?
Name of College / Institute Course Name
Course Admission Year

12th Academic Details

School Year of Result Marking Obtained
Board Stream
Name Passing Status Scheme Percentage/CGPA
MAHARASTRA
STATE BOARD
OF
Y.C.C.S
12th SECONDARY SCIENCE 2016 DECLARED PERCENTAGE 48.00
KARAD
AND HIGHER
SECONDARY
EDUCATION

Work Experience Details

Do you have any professional / work experience? NO

Payment Details
Payment Type YEARLY WISE Loan / offline payment NO
Payment Date 01/07/2024 01:14 PM

Upload Documents

Passport Sized Photograph Signature

10th or Equivalent
Aadhar Card (Both Side) YES YES
Marksheet
Diploma Or Equivalent 12th or Equivalent
NO YES
Marksheet Marksheet
Undertaking for
Graduation Marksheet
NO Submission of Eligibility NO
(Both Side)
documents
Gazette Certificate (If
Caste Certificate NO NO
Applicable)

Declaration

I hereby declare that I have read and understood the conditions of eligibility for the programme for which I seek admission. To the
best of my knowledge and belief, I fulfill the minimum eligibility criteria and I have provided necessary information and relevant
documents with this application. I further undertake that I have not concealed or distorted any other information and in the event
of any information or uploaded documents being found to be incorrect, false or misleading, my candidature shall be liable for
cancellation by the University at any time and I shall have no claim of any nature including refund of any fee paid by me and all
the benefits availed by me shall be summarily withdrawn. I do undertake that I have carefully studied the rules of the University
as given in the prospectus and I accept them in totality and shall not raise any dispute over the same. I do understand that the
university can amend or change any rules without advance intimation and I will be abiding by them.

I further declare that in the event of admission being granted to me and my obtaining a degree/diploma/certificate from BVDU -
CDOE based on concealment of any relevant information or incorrect/misleading information related to Age, Qualification and
Eligibility provided by me, I shall be solely responsible for the consequence(s) arising out of such concealment of information or
providing incorrect/misleading information; and that, the University shall not be responsible in any manner.
Applicant Name Parent Name