Sonam College Form

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For Office Use

Batch: Scrutiny Payment: Online/DD PI

Serial:
Only

Dahanukar College of Commerce (114)


Dixit Road. Andheri Application No :
University of Mumbai
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
339911
Academic Year: 2022-2023 Regular
APPLICATION FORM

Course Applied for : B.Sc. (I.T.)(with Credits) - Regular - Rev16 - F.Y. B.Sc. (I.T.) Sem I (42300003) PRN:
Application Date : 14/06/2022 Payment Category :
1.Personal Information
Candidate's Name(Regional) : सोनम विश्वकर्मा
SONAM VISHWAKARMA
Candidate's Name as printed on
[*This name will appear on all University
Mark sheet :
records/documents]
Father's/Husband's Name : BHOLESHANKAR Mother's Name : SUHAGMATI
Marital Status : UnMarried Mother Tongue : Hindi
Place Of Birth : Uttar PRADESH Gender : Female Date of Birth (DD/MM/YYYY) : 20/07/2004
Blood Group : APositive Religion : Hindu Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
District : Mumbai City/Town/Village :
State : Maharashtra Tehsil : Andheri Location Area : Rural
Suburban MUMBAI
Address (House
no,street/area/suburb KALINA CHUNNA BHATTI ANWARLALA COMPOUND SHASTRINAGAR Pin Code : 400029
etc.) :
Permanent Address :
District : Mumbai City/Town/Village : Location Area : Not
State : Maharashtra Tehsil : Andheri
Suburban MUMBAI Available
Address : KALINA CHUNNA BHATTI ANWARLALA COMPOUND SHASTRINAGAR Pin Code : 400029
Contact details
Mobile
9321992130 Email ID: pankajvishwakarma2130@gmail.com
Number
2.Legal Reservation Information
Category Type :
Category : GEN Is EWS? : Yes
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
USIT101 - Imperative Programming USIT102 - Digital Electronics
USIT103 - Operating Systems USIT104 - Discrete Mathematics
USIT105 - Communications Skills USIT1P1 - Imperative Programming Practical
USIT1P2 - Digital Electronics Practical USIT1P3 - Operating Systeams Practical
USIT1P4 - Discrete Mathematics Practical USIT1P5 - Communications Skills Practical
Sem II

USIT201 - Object oriented programming USIT202 - Microprocessor Architecture


USIT203 - Web Programming USIT204 - Numerical and Statistical Methods
USIT205 - Green Computing USIT2P1 - Object Oriented Programming Practical
USIT2P2 - Microprocessor Architecture Practical USIT2P3 - Web Programming Practical
USIT2P4 - Numerical and Statistical Methods Practical USIT2P5 - Green Computing Practical

Medium of Instruction : English


4.Guardian Information
Occupation of Guardian : Farmer Annual Income of Guardian : 200000
5.Educational Details
Month
Name of Name of Board/University Name of and Exam Certificate Mark Out
CGPA %
Examination and State of University School/College Year of Seat No. No. Obtained of
Passing
MAHARASHTRA STATE BOARD
OF SECONDARY AND HIGHER SUNDAR NAGAR
Std 10th July 2020 A276999 258180 518.02 600.00 -- - -- 86.34
SECONDARY KALINA B.M.C
EDUCATION,Maharashtra
MAHARASHTRA STATE BOARD ST. MARY'S HIGH
Std 12th OF SECONDARY AND HIGHER SCHOOL AND June
M069186 -- 438.00 600.00 -- - -- 73.00
Science SECONDARY JUNIOR 2022
EDUCATION,Maharashtra COLLEGE
Your Last Qualifying Exam: HSC/Std 12th [Science]
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.

Passing Certificate of Std 10th.

Passing Certificate of Std. 12th/Statement of Marks of std.12th.

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 :339911
(SONAM VISHWAKARMA) 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 Mon Jul 11 2022 10:12:36 GMT+0530 (India Standard Time)

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