STUDENT COPY

VASUNDHARA ARTS COLLEGE,SOLAPUR (6576A) Application No :

Yashwantrao Chavan Maharashtra Open University
Dnyangangotri Near Gangapur Dam, Nashik, Pin Code-422222, Maharashtra(India)
362640
Academic Year: 2024-2025 Distance Education
ADMISSION FORM

Course Applied for : G01-B.A.(with Credits) - Distance Education -

2000 Pattern - S.Y.B.A. (G01)
PRN:2023017001135831

Application Date : 31/07/2024 Payment Category : 8

Exam Center Name [Code] : - [-]
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed
JAISWAL CHANDANI DILIP
on School leaving/Passing
[*This name will appear on all University records/documents]
Certificate :
Mother's
Father's/Husband's Name : DILIP URMILA
Name :
Mother
Marital Status : UnMarried
Tongue :
Place Of Birth : Solapur Gender : Female Date of Birth (DD/MM/YYYY) : 01/12/2002
Blood Group : Religion : Country of Citizenship : India
Weight : Not
Height : Not Available Hemoglobin : Not Available
Available
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Solapur Tehsil : Solapur(s) City/Town/Village :
Available
Address (House
no,street/area/suburb Indira Nagar Solapur Solapur Pin Code : 413004
etc.) :
Contact details
Mobile Primary Email ID:
918999975391
Number [email protected]
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:
S.Y.B.A.
ENG214 - How to Read a Short Story ENG215 - How to Read a Novel
ECO218 - Anshlaxyi Aarthashashtra ECO219 - Samagralaxyi Aarthashashtri
HIS220 - Aadhunik Bharatcha Itihas HIS221 - Aadhunik Jagacha Itihas
EVS201 - Environment Studies
T.Y. B.A.

Medium of Instruction : Marathi

Admission Fee Payment
Fee Category : Regular Fees Over All Payment Status: : Paid
Details
Sports Fees(N) - 50 NSS Fees(N) - 10
Disaster Management Fees(N) - 10 Chancellor Office Events Fees(N) - 38
Registration Fee(N) - 200 Eligibility Fees(N) - 0
Identity Card Fees(N) - 0 E-Suvidha / E-Services Fees(N) - 60
Library Fee(N) - 10 DSW Fees(N) - 50
Alumni Fees(N) - 0 Sanvad Fees(N) - 10
Graduation/Convocation Fees(N) - 0 Student Insurance Fees(N) - 10
Tuition Fees(N) - 1600 Adm Examination Fees(N) - 1260
Course Exemption Fees(N) - 0 Prospectus Fees(N) - 50
Tuition Fees(LSC - 2nd Year)(N) - 600 Total : 3958
Payment
Amount Transaction Date Transaction Number Transaction Type
Status
3958 Paid 31/07/2024 02:13:11 2661271722435191477 Online Payment
4.Guardian Information
Occupation of Guardian : Business Annual Income of Guardian : 300000
5.Educational Details
Month and Exam
Name of Name of Board/University Name of Certificate Mark Out
Year of Seat CGPA %
Examination and State of University School/College No. Obtained Of
Passing No.
MAHARASHTRA STATE
Std 12th 12Th BOARD OF SECONDARY February
-- -- 526.00 650.00 -- - -- 80.92
(Science) AND HIGHER SECONDARY 2020
EDUCATION,
Your Last Qualifying Exam:
7.Other Information
Would you like to apply for Hostel accommodation required NA
Required Documents and Certificates Section:
Statement of Marks of Qualifying Exam (पात्रता परीक्षेची गुण पत्रिका)

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 )
[STUDY CENTER COPY]

VASUNDHARA ARTS COLLEGE,SOLAPUR (6576A) Application No :

Yashwantrao Chavan Maharashtra Open University
Dnyangangotri Near Gangapur Dam, Nashik, Pin Code-422222, Maharashtra(India)
362640
Academic Year: 2024-2025 Distance Education
ADMISSION FORM

Course Applied for : G01-B.A.(with Credits) - Distance Education -

PRN:2023017001135831
2000 Pattern - S.Y.B.A. (G01)

Application Date : 31/07/2024 Payment Category : 8

Exam Center Name [Code] : - [-]
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed
JAISWAL CHANDANI DILIP
on School leaving/Passing
[*This name will appear on all University records/documents]
Certificate :
Mother's
Father's/Husband's Name : DILIP URMILA
Name :
Mother
Marital Status : UnMarried
Tongue :
Place Of Birth : Solapur Gender : Female Date of Birth (DD/MM/YYYY) : 01/12/2002
Blood Group : Religion : Country of Citizenship : India
Weight : Not
Height : Not Available Hemoglobin : Not Available
Available
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Solapur Tehsil : Solapur(s) City/Town/Village :
Available
Address (House
no,street/area/suburb Indira Nagar Solapur Solapur Pin Code : 413004
etc.) :
Contact details
Mobile Primary Email ID:
918999975391
Number [email protected]
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:
S.Y.B.A.
ENG214 - How to Read a Short Story ENG215 - How to Read a Novel
ECO218 - Anshlaxyi Aarthashashtra ECO219 - Samagralaxyi Aarthashashtri
HIS220 - Aadhunik Bharatcha Itihas HIS221 - Aadhunik Jagacha Itihas
EVS201 - Environment Studies
T.Y. B.A.

Medium of Instruction : Marathi

Admission Fee Payment
Fee Category : Regular Fees Over All Payment Status: : Paid
Details
Sports Fees(N) - 50 NSS Fees(N) - 10
Disaster Management Fees(N) - 10 Chancellor Office Events Fees(N) - 38
Registration Fee(N) - 200 Eligibility Fees(N) - 0
Identity Card Fees(N) - 0 E-Suvidha / E-Services Fees(N) - 60
Library Fee(N) - 10 DSW Fees(N) - 50
Alumni Fees(N) - 0 Sanvad Fees(N) - 10
Graduation/Convocation Fees(N) - 0 Student Insurance Fees(N) - 10
Tuition Fees(N) - 1600 Adm Examination Fees(N) - 1260
Course Exemption Fees(N) - 0 Prospectus Fees(N) - 50
Tuition Fees(LSC - 2nd Year)(N) - 600 Total : 3958
Payment
Amount Transaction Date Transaction Number Transaction Type
Status
3958 Paid 31/07/2024 02:13:11 2661271722435191477 Online Payment
4.Guardian Information
Occupation of Guardian : Business Annual Income of Guardian : 300000
5.Educational Details
Month and Exam
Name of Name of Board/University Name of Certificate Mark Out
Year of Seat CGPA %
Examination and State of University School/College No. Obtained Of
Passing No.
MAHARASHTRA STATE
Std 12th 12Th BOARD OF SECONDARY February
-- -- 526.00 650.00 -- - -- 80.92
(Science) AND HIGHER SECONDARY 2020
EDUCATION,
Your Last Qualifying Exam:
7.Other Information
Would you like to apply for Hostel accommodation required NA
Required Documents and Certificates Section:
Statement of Marks of Qualifying Exam (पात्रता परीक्षेची गुण पत्रिका)

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 Wed Jul 31 2024 14:14:50 GMT+0530 (India Standard Time)