Mu Admission Form

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Shri Vile Parle Kelavani Mandal's

MITHIBAI COLLEGE OF ARTS, CHAUHAN INSTITUTE OF SCIENCE & AMRUTBEN JIVANLAL


COLLEGE OF COMMERCE AND ECONOMICS
NARSEE MONJEE COLLEGE OF COMMERCE & ECONOMICS
USHA PRAVIN GANDHI COLLEGE OF ARTS, SCIENCE & COMMERCE
(AFFILIATED TO THE UNIVERSITY OF MUMBAI)
Application No.
Tel. :- MITHIBAI : 42339000/01 NM: 42338000/01 UPG : 42332041/42
000600468466
Academic Year : 2019 - 20
Program Applied for* BCOM : Bachelor Of Commerce

Category* Open

College Prefernce 1 NM College Univ. Appl. No. 1098275

MITHIBAI COLLEGE OF ARTS, CHAUHAN INSTITUTE OF


College Prefernce 2 Univ. Appl. No. 1108587
SCIENCE & AMRUTBENJIVANLAL COLLEG

HSC / Equiv. Exam Passing Country* India

Pre-Admission
HSC / Equiv. Stream HSC Regular HSC Stream SCIENCE

Marks obtained at HSC / Equiv. Exam.* 525 Out of* 600 Marks 87.5 % Converted to 600 Marks 525 87.5 %
State the total marks obtained of all the subjects
Applicant Status * Passed in One attempt Passed in more than one attempts
Personal Details : ( Full Name as printed on XII Marksheet )

Gender*
Form
Salutation*
Mr

Male

Local Address For Correspondence


Last Name*

AGRAWAL
First Name*

OJUSH
Father's / Middle Name*
MURARI LAL AGRAWA

Birth Date* DD.MM.YYYY 24.05.2001


Mother's Name*

POONAM AGRAWAL

SANGITARAI BY PASS ROAD , ATAL CHOWK , DURGA RICE MILL


RAIGARH, Chhattisgarh, 496001
E - mail ID : ojushagrawal271@gmail.com
Telephone No. : Mobile No. : 9131508123

Educational Details
Month & Year Marks Marks
Exam Board Seat No. % Name of Institute Address of Institute
of Passing Obtained Out of
CARMEL CONVENT
X ICSE 05 2017 444 600 74 SENIOR SECONDARY RAIGARH
SCHOOL
CHRIST JUNIOR
Declaration
XII /
Equiv. HSC : I hereby
04 declare that I have registered
2019 525myself600
at the University
87.5 website http://mum.digitaluniversity.ac.
COLLEGE- BANGALORE
I certify and declare that the information provided by me in the Pre-admission Online RESIDENTIAL
Registration Form and the Online Admission
Form is same and correct. In case of any discrepancy and/or submission of incomplete form I am aware that my form will be rejected
and that I shall loose my claim on the admission and that I shall not hold the college authorities responsible for the same.
I am aware of the University of Mumbai ordinance 6086 relating to the minimum 75% requirement of attendance of learners.
I abide by the rules and regulation of the college. Also , I understand the management of the college reserves the right of admission .

Name & Signature of the Student


No Pre-Admission form will be processed or considered without Online Payment of application processing fees

Page 1 of 1 User: OJUSHAGRAW Application No. 000600468466

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