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Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon

http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
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PRN: Eligibility Status: Examination form No.:


117569
2016015400333344 Eligible

Instruction Medium: Nationality: India


Student's Name: PATIL PRASHANT CHATUR Mother's Name: SARLA Gender: Male
Name in Vernacular Language: ”ȡǑŠ›ĤžȡȲ…Ǖš
Address: SWAMI NARAYAN NAGAR PAROLA JALGAON
City: PAROLA, Taluka: Parola, District: Jalgaon, State: Maharashtra, PIN: 425111
Telephone no.: Mobile no: 919096245297 Email : PPRASHANT668@GMAIL.COM
DOB: May 07, 1998 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):
2. Sem-III(Regular-under CBCS [June-2020] Pattern- Previous Details: Sem-III(Regular-under CBCS [June-2020] Pattern), Dec-2021, Seat No.: 384984, Result:
No Branch) ATKT
Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
2 251306 CA LAB-IX LAB on Design and Analysis of Algorithms PR-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp

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