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    Application No: Regular: Munshi Nagar. Andheri M.G.Road, Fort, Mumbai-400032, Maharashtra (India) Academic Year: 2021-2022

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    PIGILI SRINIVASARAO
    The document appears to be an application form for admission to a Bachelor of Science program in Biotechnology at the University of Mumbai, as it contains personal information of the applicant such as name, date of birth, address, educational qualifications, category for reservation, and a declaration signed by the applicant. It also lists the specific papers selected for study in the first and second semesters and includes spaces for recommendations and signatures from the college.

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    Application No: Regular: Munshi Nagar. Andheri M.G.Road, Fort, Mumbai-400032, Maharashtra (India) Academic Year: 2021-2022

    Uploaded by

    PIGILI SRINIVASARAO
    27 views2 pages
    The document appears to be an application form for admission to a Bachelor of Science program in Biotechnology at the University of Mumbai, as it contains personal information of the applicant such as name, date of birth, address, educational qualifications, category for reservation, and a declaration signed by the applicant. It also lists the specific papers selected for study in the first and second semesters and includes spaces for recommendations and signatures from the college.

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    The document appears to be an application form for admission to a Bachelor of Science program in Biotechnology at the University of Mumbai, as it contains personal information of the applicant such as name, date of birth, address, educational qualifications, category for reservation, and a declaration signed by the applicant. It also lists the specific papers selected for study in the first and second semesters and includes spaces for recommendations and signatures from the college.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    27 views2 pages

    Application No: Regular: Munshi Nagar. Andheri M.G.Road, Fort, Mumbai-400032, Maharashtra (India) Academic Year: 2021-2022

    Uploaded by

    PIGILI SRINIVASARAO
    The document appears to be an application form for admission to a Bachelor of Science program in Biotechnology at the University of Mumbai, as it contains personal information of the applicant such as name, date of birth, address, educational qualifications, category for reservation, and a declaration signed by the applicant. It also lists the specific papers selected for study in the first and second semesters and includes spaces for recommendations and signatures from the college.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    For Office Use

    Batch: Scrutiny Payment: Online/DD PI

    Serial:
    Only

    Bhavans College OR Bhartiya Vidya Bhavans M. M. College of Arts, N.M. Institute of Science and H.R.J. Application
    College of Commerce (115)

    Munshi Nagar.
    Andheri
    No :

    University of Mumbai
    M.G.Road, Fort, Mumbai-400032, Maharashtra(India)

    1498060

    Academic Year: 2021-2022 Regular


    APPLICATION FORM

    Course Applied for : B.Sc. (Biotechnology)(Autonomous)(with Credits) - Regular - CBCS - F.Y.B.Sc. PRN:
    (Biotechnology)(Autonomous) Sem I 
    (-)

    Application Date : 13/08/2021 Payment Category :


    1.Personal Information
    Candidate's Name(Regional) : పిగిలి అఖిల్ కుమార్
    PIGILI AKHIL KUMAR
    Candidate's Name as printed on
    [*This name will appear on all University

    Mark sheet :
    records/documents]
    Father's/Husband's Name : SRINIVASARAO PIGILI Mother's Name : SUBHASHINI
    Marital Status : UnMarried Mother Tongue : Telugu
    Place Of Birth : Ongole Gender : Male Date of Birth (DD/MM/YYYY) : 18/01/2004
    Blood Group : Religion : Hindu Country of Citizenship : India
    Is Student NRI/ Foreign National : No Domicile State: Andhra Pradesh
    Address For Correspondence :
    City/Town/Village :
    State : Andhra Pradesh District : Prakasam Tehsil : Ongole Location Area : Urban
    Ongole
    Address (House
    no,street/area/suburb 37-1-1-14 ANNAVARAPADU 4 LINE ONGOLE Pin Code : 523001
    etc.) :
    Permanent Address :
    City/Town/Village :
    State : Andhra Pradesh District : Prakasam Tehsil : Ongole Location Area : Urban
    Ongole
    Address : 37-1-1-14 ANNAVARAPADU 4 LINE ONGOLE Pin Code : 523001
    Contact details
    Mobile
    8074781941 Email ID: [email protected]
    Number
    2.Legal Reservation Information
    Category Type :
    Category : OBC Sub Category : Kshatriya
    Reserved
    Is Specially Abled? No
    3.Social Information(Additional Inforamtion)
    Ward of Primary Teacher
    Paper Selected for:
    Sem I
    BSC BT 1.1 - Paper 1 BSC BT 1.2 - Paper 2
    BSC BT 1.3 - Paper 3 BSC BT 1.4 - Paper 4
    Sem II

    BSC BT 2.1 - Paper 1 BSC BT 2.2 - Paper 2


    BSC BT 2.3 - Paper 3 BSC BT 2.4 - Paper 4
    Medium of Instruction : English
    4.Guardian Information
    Occupation of Guardian : Farmer Annual Income of Guardian : 0
    5.Educational Details
    Month
    Name of
    Name of Name of and Year Exam Seat Certificate Mark
    Board/University and Out of CGPA %
    Examination School/College of No. No. Obtained
    State of University
    Passing
    ANDRA PRADESH BOARD
    GUNTUR
    OF SECONDARY 9.3
    -
    Std 10th OXFORD EM May 2019 1916101247 -- - - -
    EDUCATION,Andhra A
    HIGH SCHOOL
    Pradesh
    ANDRA PRADESH BOARD
    SRI CHAITANYA
    Std 12th OF INTERMEDIATE
    JUNIOR May 2021 2107211333 -- 744.00 1000.00 --
    -
    -- 74.40
    Science EDUCATION,Andhra
    COLLEGE
    Pradesh
    Your Last Qualifying Exam: HSC/Std 12th [Science]
    7.Other Information
    Would you like to apply for Hostel accommodation required NA
    Required Documents and Certificates Section:
    Passing Certificate of Std 12th / Statement of Marks of Std 12th OR Original Passing Certificate /Statement of Marks of Last
    Qualifying Exam like degree,diploma,etc.

    Certificate of Caste with Category.

    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
    Application No :1498060
    (PIGILI AKHIL KUMAR)
    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 )
    For College/Institute/Study Center Use Only
    Designation Signature and
    Remarks / Particulars / Recommendations
    Date
    Admission Clerk
    Admission
    Committee
    Accountant/Cashier Cash Received: INR Receipt No.: Date:
    Registrar/Office
    Superintendent
    Document printed on Fri Aug 13 2021 23:24:53 GMT+0530 (India Standard Time)

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