esU ecffiO roF
Batch: Scrutiny Payment: Online/DD PI
yl n O Serial:
Suman Educational Trusts Dilkap Research Institute of Engineering and Management Studies (857)
Application No :
University of Mumbai
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
600945
Academic Year: 2024-2025 Regular
APPLICATION FORM
Course Applied for : B.E.(with Credits) - Regular - CBCS - Computer PRN:2021016402118136
Engineering - T.E. C-Scheme Sem V (BECBCS1001)
Application Date : 07/05/2025 Payment Category : 25
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed CHAWAN ROHAN PARSHURAM
on Mark sheet : [*This name will appear on all University records/documents]
Mother's
Father's/Husband's Name : PARSHURAM
Name : SANGEETA
Mother
Marital Status : UnMarried
Tongue :
Place Of Birth : Kalwa THANE Gender : Male Date of Birth (DD/MM/YYYY) : 08/06/2003
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
no,street/area/suburb ROOM NO. 133 PARSHURAM CHAWAN SAMRAT ASHOK NAGAR ROAD Pin Code : 400605
KALWA {E}
etc.) :
Contact details
Mobile
Number 8691960906 Email ID: [email protected]
2.Legal Reservation Information
Category Type :
Open
Category : GEN
Is Guardian from EBC (Economic
Is Specially Abled? No Backward Class)? No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem V
CSC501 - Theoretical Computer Science CSC502 - Software Engineering
CSC503 - Computer Network CSC504 - Data Warehousing & Mining
CSL501 - Software Engineering Lab CSL502 - Computer Network Lab
CSL503 - Data Warehousing & Mining Lab CSL504 - Professional Comm. & Ethics II
CSM501 - Mini Project : 2A CSDLO5012 - Internet Programming
Sem VI
CSDLO6011 - Internet of Things CSC601 - System Programming and Compiler Construction
CSC602 - Cryptography and System Security CSC603 - Mobile Computing
CSC604 - Artificial Intelligence CSL601 - System Programming & Compiler Construction Lab
CSL602 - Cryptography & System Security Lab CSL603 - Mobile Computing Lab
CSL604 - Artificial Intelligence Lab CSL605 - Skill base Lab Course: Cloud Computing
CSM601 - Mini Project 2B
Medium of Instruction : English
4.Guardian Information
Occupation of Guardian : Business Annual Income of Guardian : 120000
5.Educational Details
Month Exam
Name of Name of Board/University Name of and Year Seat Certificate Mark Out CGPA %
Examination and State of University School/College of Passing No. No. Obtained of
MAHARASHTRA STATE
BOARD OF SECONDARY March
Std 10th -- -- 274.00 500.00 -- - -- 54.80
AND HIGHER SECONDARY 2019
EDUCATION,
MAHARASHTRA STATE
Std 12th 12Th BOARD OF SECONDARY
June 2021 -- -- 330.00 600.00 -- - -- 55.00
(Science) AND HIGHER SECONDARY
EDUCATION,
MAHARASHTRA STATE
Certificate : BOARD OF SECONDARY
June 2021 -- -- 330.00 600.00 -- - -- 55.00
HSC Certificate AND HIGHER 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 Wed May 07 2025 16:08:10 GMT+0530 (India Standard Time)
