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Application No: Regular: M.G.Road, Fort, Mumbai-400032, Maharashtra (India) Academic Year: 2020-2021

This document is an application form for Chinmay Sharad Ajgaonkar to enroll in the M.Com. Part II Sem III course at Keraleeya Samajam (REGD.) Dombivlis Model College which is affiliated with the University of Mumbai. The application provides personal details of Chinmay such as name, date of birth, address, contact information, educational qualifications including SSC, HSC, and BMS degrees, guardian information, and a declaration signed by Chinmay affirming the truth and completeness of the information provided.
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0% found this document useful (0 votes)
307 views2 pages

Application No: Regular: M.G.Road, Fort, Mumbai-400032, Maharashtra (India) Academic Year: 2020-2021

This document is an application form for Chinmay Sharad Ajgaonkar to enroll in the M.Com. Part II Sem III course at Keraleeya Samajam (REGD.) Dombivlis Model College which is affiliated with the University of Mumbai. The application provides personal details of Chinmay such as name, date of birth, address, contact information, educational qualifications including SSC, HSC, and BMS degrees, guardian information, and a declaration signed by Chinmay affirming the truth and completeness of the information provided.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

8/20/2020

For Office Use


Batch: Scrutiny Payment: Online/DD PI

Only Serial:

Keraleeya Samajam (REGD.) Dombivlis Model College (102)


Application No :
University of Mumbai 2732037
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
Academic Year: 2020-2021
Regular
APPLICATION FORM

Course Applied for : M.Com.(with Credits) - Regular - Rev16 - M.Com. Part II Sem III [2C00533] (-) PRN:2016016400991787
Application Date : 20/08/2020 Payment Category : 35

1.Personal Information

Candidate's Name(Regional) :
Candidate's Name as printed on Mark AJGAONKAR CHINMAY SHARAD
sheet : [*This name will appear on all University records/documents]
Father's/Husband's Name : SHARAD AJGAONKAR Mother's Name : SEEMA

Marital Status : UnMarried Mother Tongue :


Place Of Birth : DOMBIVLI Gender : Male Date of Birth (DD/MM/YYYY) : 29/11/1998
Blood Group : Religion : Country of Citizenship : India
Height : Not Available Weight : Not Available Hemoglobin : Not Available
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
3/20, VINIT CHS , AMBIKA NAGAR , GOGRASWADI , DOMBIVLI EAST Pin Code : 421201
no,street/area/suburb etc.) :
Contact details
Mobile Number 917506015940 Email ID: CHINMAYAJGAONKAR@GMAIL.COM
2.Legal Reservation Information
Category Type : Open Category : GEN
Is Specially Abled? No
3.Social Information(Additional Inforamtion)

Paper Selected for:


Sem III [2C00533]
UMCISIII.6 - Project Work I 72203 - Commercial Bank Management
72208 - Financial Markets 72213 - Accounting of Banking Sector
Sem IV [2C00534]

UMCISIV.6 - Project Work II 67503 - International Finance


67508 - Financial Services 67518 - Investment Management

Medium of Instruction : English


4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 300000
5.Educational Details
Month and Exam
Name of Name of Board/University and State of Name of Certificate Mark
Year of Seat Out of CGPA %
Examination University School/College No. Obtained
Passing No.
MAHARASHTRA STATE BOARD OF
Std 10th SECONDARY AND HIGHER March 2014 -- -- 328.00 500.00 -- - -- 65.60
SECONDARY EDUCATION,

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8/20/2020

Month and Exam


Name of Name of Board/University and State of Name of Certificate Mark
Year of Seat Out of CGPA %
Examination University School/College No. Obtained
Passing No.
MAHARASHTRA STATE BOARD OF
Std 12th 12Th February
SECONDARY AND HIGHER -- -- 483.00 650.00 -- - -- 74.31
(Commerce) 2016
SECONDARY EDUCATION,
Degree : B.M.S.
(With Credits)- Passed -- -- - - -- - -- -
Regular-Rev16
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 Thu Aug 20 2020 19:37:59 GMT+0530 (India Standard Time)

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