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For Office Use
Batch: Scrutiny Payment: Online/DD PI
Only Serial:
Shree L. R. Tiwari College of Engineering (890)
Application No :
University of Mumbai 596081
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
Academic Year: 2024-2025
Regular
APPLICATION FORM
Course Applied for : B.E.(with Credits) - Regular - CBCS - Electronics and PRN:2020016402058015
Computer Science - B.E. C-Scheme Sem VII (BECBCS1001)
Application Date : 10/03/2025
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed on SHARMA RAHUL KARUNESH
Mark sheet : [*This name will appear on all University records/documents]
KARUNESH
Father's/Husband's Name : Mother's Name : NEETU SHARMA
SHARMA
Marital Status : UnMarried Mother Tongue :
Place Of Birth : Gender : Male Date of Birth (DD/MM/YYYY) : 31/05/2003
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 : Thane Tehsil : Thane City/Town/Village :
Available
Address (House
A WING 304 GAGAN DEEP BLDG PLEASENT PARK MIRA ROAD EAST THANE Pin Code : 401107
no,street/area/suburb etc.) :
Contact details
Mobile Number 917045313220 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 VII
89351 - VLSI Design 89352 - Internet of Things
ECL701 - VLSI Design Lab ECL702 - Internet of Things Lab
ECL703 - Department Level Optional Course - III Lab. ECP701 - Major Project - I
89355 - Big Data Analytics 89357 - Cloud Computing
89366 - Cyber Security and Laws
Sem VIII
89371 - Robotics ECL801 - Robotics Lab
ECL802 - Department Level Optional Course - V Lab ECP801 - Major Project II
89375 - Advanced Algorithms 89376 - Advanced Networking Technologies
89388 - Environmental Management
Medium of Instruction : English
4.Guardian Information
Occupation of Guardian : Business Annual Income of Guardian : 200000
5.Educational Details
Month and Exam
Name of Name of Board/University and State Name of Certificate Mark
Year of Seat Out of CGPA %
Examination of University School/College No. Obtained
Passing No.
MAHARASHTRA STATE BOARD OF
Std 10th SECONDARY AND HIGHER June 2018 -- -- 379.00 500.00 -- - -- 75.80
SECONDARY EDUCATION,
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Month and Exam
Name of Name of Board/University and State Name of Certificate Mark
Year of Seat Out of CGPA %
Examination of University School/College No. Obtained
Passing No.
MAHARASHTRA STATE BOARD OF
Std 12th 12Th
SECONDARY AND HIGHER June 2020 -- -- 401.00 650.00 -- - -- 61.69
(Science)
SECONDARY 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 Mon Mar 10 2025 11:34:15 GMT+0530 (India Standard Time)
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