RV Educational Institutions

SSMRV College
# 17, 26th Main, 36th Cross, 4th 'T' Block, Jayanagar, Bengaluru-560041
Affiliated to Bengaluru Central University
NAAC Accredited 'A' Grade
Phone: 080-22453665 | Email : [email protected] | Website : ssmrv.edu.in

ADMISSION APPLICATION FORM - UG

Application No. 100000030174 Student ID:

Date of admission: Student No:
Program : BACHELOR OF COMMERCE
Specialization : GENERAL

STUDENT DETAILS
Applicant's Full Name : PRAJWAL SHIVSHANKAR

First Name: PRAJWAL Middle Name : Last Name : SHIVSHANKAR

Gender : MALE Date of Birth: 13.05.2003 Place of Birth: HARAGADDE

Blood Group: B+ Category: OBC Aadhaar No.: 687922917848

Nationality: INDIAN Religion: HINDU Urban / Rural : RURAL

Caste: LINGAYAT Sub Caste : VEERASHAIVA Differently abled : NOT APPLICABLE

LOCAL ADDRESS

HARAGADDE, HARAGADDE POST,

Line 1: Line 2: HARAGADDE, HARAGADDE POST, JIGANI
JIGANI

City / Town: ANEKAL PIN / ZIP Code: 562107

State: KARNATAKA Country: INDIA

Mobile No. +919740878529 Telephone No.: 9740878529

Email Id : [email protected]

PERMANENT ADDRESS

SURAGAJAKANAHALLI NEAR PUNCHER SURAGAJAKANAHALLI NEAR PUNCHER

Line 1: Line 2:
SHOP SHOP

City / Town: ANEKAL Country: INDIA

State: KARNATAKA PIN / ZIP Code: 562107

Hostel Facility Required

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FAMILY INFORMATION

FATHER

Name : SHIVSHANKAR H P Occupation : BUSINESS MAN

Telephone No: 9740878529 Mobile No: 9035921486 Email : [email protected]

Address :

HARAGADDE, HARAGADDE
Line1: HARAGADDE, HARAGADDE POST, JIGANI Line2:
POST, JIGANI

City/Town: ANEKAL PIN / ZIP Code : 560105

Country: INDIA State: KARNATAKA

MOTHER

Name: MADHAVI R Occupation: HOUSE WIFE

Telephone No : Mobile No. +919740878529 Email: [email protected]

Address :

HARAGADDE, HARAGADDE
Line1 : HARAGADDE, HARAGADDE POST, JIGANI Line2 :
POST, JIGANI

City/Town : ANEKAL PIN / ZIP Code : 560105

Country : INDIA State : KARNATAKA

Parent's Annual Income : 400000

GUARDIAN

Name: Relationship with the Applicant:

Telephone No: Mobile No: Email:

Address:

Line1: Line2:

City/Town: PIN / ZIP Code :

Country: State:

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 Examination Name of the institution and place Reg No Name of the Board Max. Marks % or CGPA Month & Year of
Marks Obtained pass

SSLC ICSE
PUC I STATE
PUC II STATE

PREVIOUS EDUCATION DETAILS

Name of the College Name of the Board
Last studied :
HOLY SPIRIT PU COLLEGE last studied :
STATE

Medium of Instruction
in Previous Class :
ENGLISH Previous Combination : ESBA

Total Marks in
Previous Examination :
600 Total Marks in Optional Subjects : 400

Marks obtained in
Previous Examination :
425 Marks obtained in Optional Subjects : 266

Percentage of marks in Previous

Examination :
70.8 Percentage of marks in Optional Subjects : 66.5
Subject Max Marks Marks Obtained Register Number Result Year of Passing
Kannada 100 57 20AS696C0093 PASS 2020
English 100 75 20AS696C0093 PASS 2020
Economics 100 52 20AS696C0093 PASS 2020
Business Studies 100 64 20AS696C0093 PASS 2020
Accounta 100 46 20AS696C0093 PASS 2020
Statistics 100 74 20AS696C0093 PASS 2020

Language studied in the Previous Class : ENGLISH Language opted in the Degree : ENGLISH

Sports in which interested : OTHER Representation in Sports : NONE

Extra-Curricular Activities in which interested :

Attachments

Address Proof (Aadhar ID) ✔

Caste Certificate (If Applicable)

Degree Certificate
Degree Marks Card
Income Certificate (If Applicable)
Migration Certificate
10th Marks Card
NOC ( Transfer case)
Other Documents
PGCET Allotment Letter
Fees Paid Receipt from PGCET
Student Photograph* ✔

PUC / 12th Std Marks Card*

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Transfer Certificate
FEE DETAILS ( Office Use Only )

Date of Admission :

DD towards Receipt
SLNO Payment Type Bank Name & branch DD Number DD Date DD Amount
(Type of fees) Number

DECLARATION

I promise to abide by the Rules / Regulations and orders of the Bangalore University and College . I note that my

admission is provisional and subject to approval of the University. I will submit by Original Marks card after receiving

it from my previous institution.

Date:.......................... Signature of the Candidate

Note: Parents / Guardians are requested to read the following carefully before signing.

PRAJWAL SHIVSHANKAR BACHELOR OF COMMERCE

I agree to admit of Mr / Ms.............................................................................to..............................................................

I shall be responsible for the payment of all his / her fees and fines (if any). I shall see that he / she attends classes

regularly and write all the test and examinations conducted by the college. I understand that he / she must have 75%

attendance. I also understand that if his / her attendance is below 75% he / she will not be allowed to take final

examination.

Date:.......................... Signature of the Parent / Guardian

No further correspondence will be entertained in this regard.

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