Shikshana Prasaraka Mandali's

SIR PARASHURAMBHAU COLLEGE

Affiliated to Savitribai Phule Pune University

Autonomous since June 2019-2020
Tilak Road, Sadashiv Peth, Pune - 411030 Maharashtra, INDIA
020 - 24331978, Email ID : principal@spcollegepune.ac.in
Admission Form Details (Academic Year : 2021-2022)

Form Verification (For Office Use Only) Fill Date : 10/09/2021 07:38 PM - Print Date : 10/09/2021 07:38 PM

Sign. Sign.
Div & Subject Alot. Auth Division Roll No. Rcpt. Made By Rcpt. No. Amount Date

Sign. Sign.
Form Checked By Scholarship Verification Fee Category Caste Category Caste Member ID
INDIAN Maharashtra V.J. No
Nationality State of Resident Caste Category Is Handicapped

Registration Information

Admission Form Number : 1301083

Registration Number : 1700221940

Admission Type : Section : Class :

Provisional U.G. T.Y.B.A. (CBCS)
Division : Fee Category : Caste Category :
GRANT VJ/NT V.J.
Form No. (Merit/Adm.) : Uni./Board Registration No. : Eligibility No.(UG & PG) :
N.A. N.A. 12019231796
CAP Application Kit No. : Adhaar Card No. : Pan Card No. :
N.A. 259068120000 N.A.
Saral ID. :
N.A.

Student's Information

Student's Name :
CHAVAN MALLESH SHEKHAR
Father's Name : Mother's Name :
SHEKHAR KESHAPPA CHAVAN ANITA
Local Address :
Shridhar Colony Lane No:4 Karve Nagar Pune
N.A.
Location : Taluka : District :
Karvenagar Pune City Pune
State : Country : Pin Code :
Maharashtra INDIA 411052

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Permanent Address :
Shridhar Colony Lane No.4 Karve Nagar Pune
N.A.
Location : Taluka : District :
Karvenagar Pune City Pune
State : Country : Pin Code :
Maharashtra INDIA 411052
Email ID : Mobile No. :
malleshchavan3112@gmail.com 7775952590
Parent's Email : Father's Mobile No. :
N.A. 9922691407
Father's Profession : Phone No 1 : Phone No 2 :
N.A. 9673520797 N.A.
Fax No : Gender : Birth Date :
N.A. Male 31/12/2000
Birth Place : Delivery Place : Nationality :
PUNE N.A. INDIAN
Mother Tongue : Marital Status : Occupational Status:
Marathi Single Unemployed
Blood Group : Handicap : Is Organ Donor :
O- No No.
Conveyance Use : Religion : Caste :
Bus HINDU LAMANI
Sub Caste : Caste Validity No.: Is Minority :
N.A. N.A. Religious
Minority Detail : Ration Card Type : Computer Course :
N.A. N.A. N.A.
Specialization:
Sociology

Last Year's Details with (TC/LC)/Migration/Eligibility Information

Last Attended Institute Name :

SIR PARASHURAMBHAU COLLEGE, PUNE
Last Attended Examining Body (Board/University) :
N.A.
Last Attended Class : Last Attended College/School UDISE Code :
S.Y.B.A N.A.
Eligibility : State of Residence : Last Qualified Exam :
N.A. M.S. N.A.
Passing Month : Passing Year : Percentage :
N.A. N.A. N.A.
Result : Attempt : Exam Center :
N.A. N.A. N.A.
Seat No. : T.C./L.C. No. : T.C./L.C. Date :
N.A. N.A. N.A.
Migration Cert. No. : Migration Cert. Issue Date : Gap :
N.A. N.A. N.A.

Current Year's Information

Short Term Course Offered by Inst. : Preparing for Competetive Exam :

N.A. N.A.

Consession Information

Applicable Fees Consession : Bank IFSC Code : Bank Account No :

N.A. N.A. N.A.

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Residence Type : Parent's Annual Income : Is Creamy Layer :
N.A. N.A. No
Is BPL : Social Reservation :
N.A. N.A.

Passport Information

Subject's Information

Medium : N.A.
Subject Name Subject Code Subject Group
1) Hindi Gen HD3510 Sub-Group - KAB1
2) Hindi Gen HD3610 Sub-Group - KAB1
3) History Gen HS3522 Sub-Group - KAD1
4) History Gen HS3622 Sub-Group - KAD1
5) Compulsory English CE3501 Subject Group - K
6) Compulsory English CE3601 Subject Group - K
7) Sociology Gen SO3546 Subject Group - K
8) Sociology Gen SO3646 Subject Group - K
9) Sociology Spl III SO3547 Subject Group - K
10) Sociology Spl III SO3647 Subject Group - K
11) Sociology Spl IV SO3548 Subject Group - K
12) Sociology Spl IV SO3648 Subject Group - K
13) Sociology SEC III SOSEC3 Subject Group - K
14) Sociology SEC IV SOSEC4 Subject Group - K
15) General Elective [LIFE MANAGEMENT SKILLS] GE3562 Subject Group - K
16) General Elective [VALUE EDUCATION THROUGH GE3662 Subject Group - K
HUMANITI

Previous Educational Qualification Details :

1) Institute Name : SIR PARASHURAMBHAU COLLEGE, PUNE

Board / Uniersity Name : N.A.
Qualified Course : S.Y.B.A. Obt. Marks : 1028 Max. Marks : 1400 Percentage : 73.43

Grade : First Class Attempt : 1st Month/Year : Mar/2021

CHAVAN MALLESH SHEKHAR CHAVAN MALLESH SHEKHAR

Scanned Signature Student's Signature

Undertaking

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 We hereby certify that the information provided in this application form is correct. We undertake to
abide by the rules and regulations of the college and the orders issued by the competent authorities from time
to time. We are agree that decision of the principal in respect of the student’s admission will be binding upon
us.

Parent's Signature Student's Signature

Admission Admission Not

Principal's/Vice Principal's/Authority Signature Confirmed Confirmed

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 ANTI RAGGING AFFIDAVIT BY THE STUDENT
Class : T.Y.B.A. (CBCS) -- Academic Year : 2021

Registration No. :1700221940 Date : 10/09/2021 07:38 PM

1. I, CHAVAN MALLESH SHEKHAR S/O or D/O Mr./Mrs./Ms. SHEKHAR KESHAPPA CHAVAN

having been admitted to Shikshana Prasaraka Mandali's SIR PARASHURAMBHAU COLLEGE have
received a copy of the UGC Regulations on Curbing the Menace of Ragging in Higher Educational Institutions,
2009, (hereinafter called the Regulations) carefully read and fully understood the provisions contained in the
said Regulations.
2. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.
3. I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the
penal and administrative action that is liable to be taken against me in case I am found guilty for abetting
ragging, actively or passively, or being part of a conspiracy to promote ragging.
4. I hereby solemnly aver and undertake that I will not indulge in any behaviour or act that may beconstituted
as ragging under clause 3 of the Regulations.I will not participate in or abet or propagatethrough any act of
commission or omission that may be constituted as ragging under clause 3 of the Regulations.
5. I hereby affirm that, if found guilty of ragging, I am liable for punishment according to clause 9.1 of the
Regulations, without prejudice to any other criminal action that may be taken against me under any penallaw or
any law for the time being in force.I hereby declare that I have not been expelled or debarred fromadmission in
any institution in the country on account of being found guilty of, abetting or being part of a conspiracy to
promote, ragging; and further affirm that, in case the declaration is found to be untrue, I am aware that my
admission is liable to be canceled.

Declared on ______________________

__________________________________
Signature of Student
Name : CHAVAN MALLESH SHEKHAR
Adress : Shridhar Colony Lane No:4 Karve Nagar Pune, Pune City, Karvenagar, Pune, ,
Maharashtra, INDIA, 411052

Verification
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is
false and nothing has been concealed or misstated therein.

Verified at _________________________________ on _________________________________

Signature of Student

(NOTE: There is no need to get your affidavits printed on any stamp paper or get it signed by an Notary
or an oath Commissioner.)

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 AFFIDAVIT BY PARENT/GUARDIAN
Class : T.Y.B.A. (CBCS) -- Academic Year : 2021

Registration No. :1700221940 Date : 10/09/2021 07:38 PM

1. I Mr./Mrs./Ms., SHEKHAR KESHAPPA CHAVAN father/mother/guardian of CHAVAN MALLESH

SHEKHAR having been admitted to Shikshana Prasaraka Mandali's SIR PARASHURAMBHAU
COLLEGE have received a copy of the UGC Regulations on Curbing the Menace of Ragging in Higher
Educational Institutions, 2009, (hereinafter called the Regulations) carefully read and fully understood the
provisions contained in the said Regulations.
2. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.
3. I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the
penaland administrative action that is liable to be taken against my ward in case he/she is found guilty of or
abetting ragging, actively or pasively, or being part of a conspiracy to promote ragging.
4. I hereby solemnly aver and undertake that My ward will not indulge in any behaviour or act that may be
constituted as ragging under clause 3 of the Regulations. My ward will not participate in or abet or propagate
through any act of commission or omission that may be constituted as ragging under clause 3 of the
Regulations.
5. I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according to clause 9.1 of
the Regulations, without prejudice to any other criminal action that may be taken against my ward under any
penal law or any law for the time being in force.
6. I hereby declare that my ward has not been expelled or debarred from admission in any institution in the
country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging; and
further affirm that, in case the declaration is found to be untrue, the admission of my ward is liable to be
cancelled.
Declared on ______________________

__________________________________
Signature of Parent/Guardian
Name : SHEKHAR KESHAPPA CHAVAN
Adress : Shridhar Colony Lane No.4 Karve Nagar Pune, Pune City, Karvenagar, Pune, ,
Maharashtra, INDIA, 411052

Verification
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is
false and nothing has been concealed or misstated therein.

Verified at _________________________________ on _________________________________

Signature of Parent/Guardian

(NOTE: There is no need to get your affidavits printed on any stamp paper or get it signed by an Notary
or an oath Commissioner.)

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 Undertaking Form

I am aware that I have to complete 8 Non-CGPA credits by the end of the 6th Semester and If I

do not complete the required number of credits, I will not be eligible for the award of Graduation

Degree. I will not hold the College / Department responsible for the same.