9/20/22, 10:54 PM
For Office Use
Batch: Scrutiny Payment: Online/DD PI
Only Serial:
Bhavans College OR Bhartiya Vidya Bhavans M. M. College of Arts, N.M. Institute of Application No
Science and H.R.J. College of Commerce (115)
University of Mumbai
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
2641792
Academic Year: 2022-2023 Regular
APPLICATION FORM
Course Applied for : B.Com. (Autonomous)(with Credits) - Regular - CBCS - S.Y. B.Com.(Autonomous) Sem III
(-) PRN:2021016401688215
Application Date : 20/09/2022 Payment Category : 25
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed on Mark MISTRY RUKHSAR RAFIQUE
sheet : [*This name will appear on all University records/documents]
Father's/Husband's Name : RAFIQUE Mother's Name : RAHMAT
Marital Status : UnMarried Mother Tongue :
Place Of Birth : MUMBAI Gender : Female Date of Birth (DD/MM/YYYY) : 03/05/2004
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 : Mumbai Suburban Tehsil : Andheri City/Town/Village :
Available
Address (House GOLDEN HEIGHTS 4TH FLOOR 402 MAROL CHURCH ROAD ANDHERI EAST
Pin Code : 400059
no,street/area/suburb etc.) : MUMBAI
Contact details
Mobile Number 919833510041 Email ID:
[email protected] 2.Legal Reservation Information
Category Type : Open Category : GEN
Is Guardian from EBC (Economic Backward
Is Specially Abled? No
Class)? No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem III
BCOM3001 - Paper 1 BCOM3002 - Paper 2
BCOM3003 - Paper 3 BCOM3004 - Paper 4
Sem IV
BCOM4001 - Paper 1 BCOM4002 - Paper 2
BCOM4003 - Paper 3 BCOM4004 - Paper 4
Medium of Instruction : English
4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 1000000
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.
1/2
9/20/22, 10:54 PM
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 SECONDARY June 2019 -- -- 387.00 500.00 --
-
-- 77.40
EDUCATION,
MAHARASHTRA STATE BOARD OF
Std 12th 12Th
SECONDARY AND HIGHER SECONDARY July 2021 -- -- 546.00 600.00 --
-
-- 91.00
(Commerce)
EDUCATION,
MAHARASHTRA STATE BOARD OF
Std 10th SECONDARY AND HIGHER SECONDARY June 2019 -- -- 387.00 500.00 --
-
-- 77.40
EDUCATION,
MAHARASHTRA STATE BOARD OF
Std 12th 12Th
SECONDARY AND HIGHER SECONDARY July 2021 -- -- 546.00 600.00 --
-
-- 91.00
(Commerce)
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 Sep 20 2022 22:53:06 GMT+0530 (India Standard Time)
2/2
