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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)
91230
Academic Year: 2021-2022 Regular
APPLICATION FORM

Course Applied for : B.A.(with Credits) - Regular - Rev16 - F.Y. B.A. Sem I  (12300001) PRN:
Application Date : 06/08/2021 Payment Category :
1.Personal Information
Candidate's Name(Regional) : पुरो हत मेहक मह
PUROHIT MAHEK MAHENDRA
Candidate's Name as printed on
[*This name will appear on all University
Mark sheet :
records/documents]
Father's/Husband's Name : MAHENDRA PUROHIT Mother's Name : VEENA
Marital Status : UnMarried Mother Tongue : Marwadi
Place Of Birth : Virar Mumbai Gender : Female Date of Birth (DD/MM/YYYY) : 28/05/2004
Blood Group : APositive Religion : Hindu Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
City/Town/Village :
State : Maharashtra District : Palghar Tehsil : Vasai Location Area : Urban
Mumbai
Address (House
no,street/area/suburb B/ 06,Pearl Apt. Sunder Nagar . Virar Pin Code : 401303
etc.) :
Permanent Address :
City/Town/Village :
State : Maharashtra District : Palghar Tehsil : Vasai Location Area : Urban
Mumbai
Address : B/ 06,Pearl Apt. Sunder Nagar . Virar Pin Code : 401303
Contact details
Mobile
7507443382 Email ID: [email protected]
Number
2.Legal Reservation Information
Category Type :
Category : GEN
Open
Is Specially Abled? No
3.Social Information(Additional Inforamtion)

Paper Selected for:

Sem I
UBA 1.2 - Paper I _Communication Skills in English UBAFSI.6.1 - Foundation Course - I
UBA 1.43 - PAPER I - HINDI UBA 1.35 - PAPER I - ECONOMICS THEORY
UBA 1.24 - PAPER I - GENERAL PSYCHOLOGY UBA 1.28 - PAPER I - History of Modern India (1857-1947)
Sem II

UBA 2.2 - PAPER II - COMMUNICATION SKILLS IN ENGLISH UBAFSII.6.1 - Foundation Course - II

UBA 2.43 - PAPER I - HINDI UBA 2.35 - PAPER I - ECONOMICS THEORY
UBA 2.24 - PAPER I - GENERAL PSYCHOLOGY UBA 2.28 - PAPER I - History of Modern India: Society and
Economy
Medium of Instruction : English
4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 350000
5.Educational Details
Month
Name of Name of Board/University Name of and Exam Certificate Mark
Out of CGPA %
Examination and State of University School/College Year of Seat No. No. Obtained
Passing
MAHARASHTRA STATE
ST. MARY
BOARD OF SECONDARY AND March
Std 10th ENGLISH HIGH A154059 S194201595 311.00 500.00 -- - -- 62.20
HIGHER SECONDARY 2019
SCHOOL
EDUCATION,Maharashtra
MAHARASHTRA STATE
BOARD OF SECONDARY AND BHAVAN'S April
Std 12th Arts M118201 -- 525.00 600.00 -- - -- 87.50
HIGHER SECONDARY COLLEGE 2021
EDUCATION,Maharashtra
Diploma :
Early SHREE SUBODH
Childhood SHIKSHAN January
E. C. C. E. D VR10132 -- 740.00 1000.00 -- - -- 74.00
Care PRASARAK 2021
Education SANSTHA
Diploma
Your Last Qualifying Exam: HSC/Std 12th [Arts]
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.

Passing Certificate of Std 10th.

Statement of Marks of Std 10th.

Birth Certificate.

Residence Proof (Any) – Copy of Voter ID/ Driving License/Telephone Bill /Electricity Bill /Ration Card/ Society Letter/
Agreement.

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 :91230
(PUROHIT MAHEK MAHENDRA) 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 Tue Aug 17 2021 14:29:18 GMT+0530 (India Standard Time)