Batch: Scrutiny Payment: Online/DD PI

For Office Use Serial:

Only

Rohidas Patil Institute of Management Studies (813)

Mahavidhyalaya Marg, Navghar, Bhayandar (E) Thane Application No :
University of Mumbai 2866576
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
Academic Year: 2023-2024 Regular
APPLICATION FORM

Course Applied for : M.M.S.(with Credits) - Regular - Rev16 - F.Y. PRN:2019016401276192

M.M.S. Sem I (-)

Application Date : 14/09/2023 Payment Category :

1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed PAL PANKAJ SHESHNATH
on Mark sheet : [*This name will appear on all University records/documents]
Mother's
Father's/Husband's Name : SHESHNATH URMILA
Name :
Mother
Marital Status : UnMarried
Tongue :
Place Of Birth : BHAYANDAR Gender : Male Date of Birth (DD/MM/YYYY) : 21/07/2002
Blood Group : Religion : Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Thane Tehsil : Thane City/Town/Village :
Available
Address (House
no,street/area/suburb B/206,VRAJ MANEK BUILDING NO 2 STATION ROAD BHAYANDAR WEST Pin Code : 401101
etc.) :
Contact details
Mobile
918652310930 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 I
UMMSI.1 - Perspective Management UMMSI.2 - Financial Accounting
UMMSI.3 - Business Statistic UMMSI.4 - Operations Management
UMMSI.5 - Managerial Economics UMMSI.6.3 - Ecommerce
UMMSI.6.4 - Organizational Behaviour UMMSI.6.8 - IT Skills for Management and Technology
Platform
Sem II

UMMSII.1 - Marketing Management UMMSII.2 - Fainancial Management

UMMSII.3 - Operation Reaserch UMMSII.4 - Business Reserch Methods
UMMSII.5 - Human Resource Management UMMSII.6.2 - Cost & Management Accounting
UMMSII.6.8 - Management Information System UMMSII.6.9 - Developing trems & Effective leadership

Medium of Instruction : English

4.Guardian Information
Occupation of Guardian : Business Annual Income of Guardian : 150000
5.Educational Details
Month
Name of Name of Board/University Name of Exam Certificate Mark Out
and Year CGPA %
Examination and State of University School/College Seat No. No. Obtained of
of Passing
MAHARASHTRA STATE
BOARD OF SECONDARY March
Std 10th -- -- 255.00 500.00 -- - -- 51.00
AND HIGHER SECONDARY 2017
EDUCATION,
Std 12th 12Th MAHARASHTRA STATE February -- -- 342.00 650.00 -- - -- 52.62
(Commerce) BOARD OF SECONDARY 2019
 Month
Name of Name of Board/University Name of Exam Certificate Mark Out
and Year CGPA %
Examination and State of University School/College Seat No. No. Obtained of
of Passing
AND HIGHER SECONDARY
EDUCATION,
Degree :
University of REENA MEHTA August
BACHELOR Of 1085354 -- 336.00 600.00 -- - -- 56.00
Mumbai,Maharashtra COLLEGE 2023
COMMERCE
Your Last Qualifying Exam: BACHELOR Of COMMERCE
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.

Mark/Grade Statement of Semester-V

Mark/Grade Statement of Semester-VI

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 :2866576
(PAL PANKAJ SHESHNATH) 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 Thu Sep 14 2023 13:02:07 GMT+0530 (India Standard Time)