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Parle Tilak Vidyalaya Associations Sathaye College (155)
Application No :
University of Mumbai 2458174
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
Academic Year: 2023-2024 Regular
APPLICATION FORM
Course Applied for : B.Sc. (I.T.) (Autonomous)(with Credits) -
PRN:2021016401607457
Regular - CBCS - T.Y.B.Sc. (I.T.) (Autonomous) Sem V (-)
Application Date : 22/07/2023 Payment Category : 13
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed ALVA RAKSHITH MAHABALA
on Mark sheet : [*This name will appear on all University records/documents]
Mother's
Father's/Husband's Name : MAHABALA JAYANTHI
Name :
Mother
Marital Status : UnMarried
Tongue :
Place Of Birth : Manipal Gender : Male Date of Birth (DD/MM/YYYY) : 04/11/2003
Blood Group : Religion : Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
District : Mumbai Location Area : Not
State : Maharashtra Tehsil : Andheri City/Town/Village :
Suburban Available
Address (House
no,street/area/suburb Room No 6, Mohideen Chawl, Old CST Road, Kalina Village, Santacruz East Pin Code : 400029
etc.) :
Contact details
Mobile
919769013347 Email ID:
[email protected]Number
2.Legal Reservation Information
Category Type :
Category : GEN
Open
Is Guardian from EBC (Economic
Is Specially Abled? No
Backward Class)? No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem V
BSCIT001 - PAPER I BSCIT002 - PAPER II
BSCIT003 - PAPER III BSCIT004 - PAPER IV
Sem VI
BSCIT005 - PAPER V BSCIT006 - PAPER VI
BSCIT007 - PAPER VII BSCIT008 - PAPER VIII
Medium of Instruction : English
4.Guardian Information
Occupation of Guardian : Laborer Annual Income of Guardian : 120000
5.Educational Details
Month Exam
Name of Name of Board/University Name of Certificate Mark Out
and Year Seat CGPA %
Examination and State of University School/College No. Obtained of
of Passing No.
Std 10th MAHARASHTRA STATE March -- -- 381.00 500.00 -- - -- 76.20
BOARD OF SECONDARY 2019
Month Exam
Name of Name of Board/University Name of Certificate Mark Out
and Year Seat CGPA %
Examination and State of University School/College No. Obtained of
of Passing No.
AND HIGHER SECONDARY
EDUCATION,
MAHARASHTRA STATE
Std 12th 12Th BOARD OF SECONDARY
April 2021 -- -- 483.00 600.00 -- - -- 80.50
(Science) 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 Sat Jul 22 2023 19:47:40 GMT+0530 (India Standard Time)
