‘Admission Merit Category : OPEN Maths Marks | Maths Marks out Total obtained of Total | Marks marks | out | Percentage ° ° stream | obtained | of % State Board commence | as1 | 600 | arse | mananasirra STATE BOARD ABC ID: 319655371571 Aadhaar Card No.: 893805941344 University Pre Enrollment No. : MU250194704 Malad Kandivli Education Society's ‘College Code: Nagindas Khandwala College of 139 wi Commerce, Arts & Management Studies And KES | shantaben Nagindas Khandwala College of Science (Autonomous) | piv: ‘emen (Re-Accredited (3rd Cycle) by NAAC With ‘A’ Grade) Bhavishya Bharat Campus, Bhadran Nagar, Off S.V. Road, Malad (West), Mumbai | Roll No.: = 400 064. Academic Year : 2025-2026 Application No.:FYBA) 25-26121 For College use only Application for Admission to FYBA ‘Student id: Course Applied For : FYBA Registration Ne Registration Date : 19/05/2025 1. Personal information section LastName First Name Middle Name Name of the Student ANSARI ‘SAHIL SHAMSER ‘Name of the Student (Devanagari) Father's Name SHAMSER Nameas per Aadharcard | SAHIL ANSARI Mother's Name: AFASANA, Marital Status : UnMarried Gender : Male Date of Birth : 21/03/2007 Blood Group: A+ Place of Birth : SUNDARPUR GYANPUR BHADOHI UTTAR PRADESH | Transaction Type : ONLINE Medium : English Citizenship of: Indian Religion : MUSLIM ‘Aadhar card No. : 893805941344 2. Address Details Address of ‘AMBOJWADI AZAD NAGAR MALWANI MALAD Pin Code : 400095, Correspondance: ‘State: Maharastra District : MUMBAI SUBURBAN City: MUMBAI Permanent Address. 'SUNDARPUR GYANPUR BHADOHI UTTAR PRADESH Pin Code: 221308 ‘State:UTTAR PRADESH | District : Bhadohi City : SUNDARPUR3. Contact Details (Note: Following details will be used by the college for further correspondence) Student Phone 1819653029 Parent phone : 8953065418 ‘Student Mobile No. : 9819653029 Student Email ld: shksahil368@gmailcom 4, Legal Reservation Information Section Caste Category : OPEN Sub Caste: Phy. Handicapped : 5. Subject Details Section 6. Subject Details Section For Next Semester Sr.No. | GroupName Subject Code Subject Name 2o21UAcs ‘COMMUNICATION SKILLS IN ENGLISH- I 2022UAFC. FOUNDATION COURSE II 2123UAEG ENVIRONMENTAL GEOGRAPHY 2024UAPS FUNDAMENTALS OF PSYCHOLOGY : a 2025UAEC MACROECONOMICS -1 2026UAFR FRENCH 2026UAHN HINDI 2rztuacs ‘COMMUNICATION SKILLS IN ENGLISH- I 2122UAFC FOUNDATION COURSE -11 2123UAEG ENVIRONMENTAL GEOGRAPHY SrNo. Name of Documents/Certificate 1 | AaDHaR CARD 2 | H.ScMaRKsHEET 3 | UNIVERSITY PRE ENROLLMENT FORM 4 | ABC IDCARD PHOTOCOPY 9. Guardian / Parent Information Section ‘Occupation of the Guardian/Parent ‘Annual Income of the guardian/Parent : 300000.00 Relationship of Guardian with applicant : ITSELF Guardian/Parent Phone No. : 8953065418 10. Other information Sec! Mother Tongue : HINDI Employment Status : NO Do you wish to join NCC / NSS: NO Would you like to apply for Hostel : NO Hobbies, Proficiency and Other interests : NA Sports Achievement : Personal identification Marks11. Declaration by Student hereby declare that, | have read the rules related to admission and the information filled in by me in this form is accurate and true to the best of my knowledge. | will be responsible for any discrepancy, arising out of the form signed by me and | undertake that, in absence of any document the final admission will not be granted and | or admission stand cancel. ‘ORDINANACE 0.119 RELATING TO THE ATTENDANCE Following shall be the minimum attendance necessary for keeping terms. FIRST TERM/SEMESTER ‘SECOND TERM/SEMESTER Three -Fourths of days on Th FFourths of days on Which lectures are delivered Which lectures are delivered Ordinance - 0.125 relating to the Keeping of terms to the si college faction of the Principal of a ‘To keep a term at the college of recognized Institution, an undergraduate must complete to the Satisfaction of the principal or the Head of the Institution, the course of study at the college or Institution, preseribed for such a term for the class to which such undergraduate belongs. Important Ragging is Strictly prohibited in the College permises and outside. Student including in raging other student will be punished as per the Maharashtra Prohibition of Ragging ‘Act,1999(Mah.XXXIIl of 1998) Published in Maharashtra Govt. Gazette on 15th May 1999. Such Student will also be expelled from the college and F.L.R. will be lodged with the police againt them. The Student found guilty of ragging earlier will not be this college. (UNDERTAKING BY THE STUDENTS) 1. ISAHIL SHAMSER ANSARI S.0.[D.0. of Mr./Mrs./ Ms. have carefully read and fully understood the law prohibiting ragging and the direction of the Supreme Court and the Central/State Government in this regard. 2. Ihave received a copy of the UGC Regulation on Curbing the Menace of Ragging in Higher Educational institutions, 2009 and have carefully gone through it. 3. 1hereby undertake that | will not indulge in any Behavior or act that may come under the definition of ragging. | will not participate in of abet or propagate ragging in any form. will not hurt anyone physically or psychologically or cause any other harm. 4.1 hereby agree that if found guilty of any aspect of raging. | may be punished as per the provisions of the UGC Regulation mentioned above and / or as per the law in force. 5.1 hereby affirm that | have not been expelled or debarred from admission by any institution. 6. I hereby undertake that | will register my name in the Voters List with the State Election ‘Commission, Government of Maharashtra as soon as | complete the age of 18th years. Singed this 23 day of 07 month of 2025 year Signature of Student 112. Declaration by Parent / Guardian 1. | FoJM.0,/G.0. have carefully read and fully understood the law prohibiting ragging and the direction of the Supreme Court and the Central/State Government in this regard as well as the UGC Regulation on Curbing the Menace of Ragging in higher Educational institutions, 2009. 2.1.1 assure you that my son /daughter /ward will not indulge in any act of ragging 3. I hereby agree that if he/ she is found guilty of any aspect of ragging, he/she may be Punished as per the provisions of the UGC Regulation mentioned above and] or as per the law in force. Singed this 23 day of 07 month of 2025 year Signature of the Parent / GuardianUniversity of Mumbai DECLARATION /UNDERTAKING FROM THE STUDENT |\Mr. [Ms SAHIL SHAMSER ANSARI Mobile No: 9819653029 Email. Address: shksahil368@gm that, information submitted in admission form is correct. Lcom here by declare | am confirming my admission for course FYBA at NAGINDAS KHANDWALA COLLEGE (EMPOWERED AUTONOMOUS) for academic year 2025-2026. My registration no of Mumbai University digital portal is MU250194704 agree that : 4. will not confirm my admission to any other college. 2.1 will submit my all Original Documents to the college whenever required. 2. am aware thatif information in my Admission Form is found to be wrong andor itis known that | have submitted my original documents to any other college, my admission will be treated as cancelled. Place : Mumbai Date : 23/07/2025 Signature of Student DECLARATION BY PARENT] GUARDIAN |, (Mother / Father / Guardian) hereby fully endorse the above undertakingjdeclaration given by my childjward. And | vill endeavor to induce my child/ward to do his/her best to observe the above stated undertaking in words and spirit. Place : Mumbai Date : 23/07/2025 Signature of Parent / Guardian 18, For College / Institute Use Only Designation Remarks | Particular /Recommendation Signature and Date ‘Admission Clerk ‘Admission Committee ‘Accountant /cashier Fees Paid Receipt No: Registrar/Office superintendent Principal | Director