Online Form

Download as pdf or txt
Download as pdf or txt
You are on page 1of 2

For Office Use

Batch: Scrutiny Payment: Online/DD PI

Only Serial:

Prabhakar Patil Education Societys B.ED College (849)


Near Gokuleshwar mandir in front of veshvi Ailbag Veshvi Alibag
Application No :
University of Mumbai 3729167
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
Academic Year: 2020-2021 Regular
APPLICATION FORM

Course Applied for : B.Ed.(with Credits) - Regular - Rev16 - F.Y. B.Ed. Sem I [4E00141] (-) PRN:2018016402589593
Application Date : 12/02/2021 Payment Category :

1.Personal Information

Candidate's Name(Regional) :
Candidate's Name as printed on Mark BADE ASMA YUSUF
sheet : [*This name will appear on all University records/documents]
Father's/Husband's Name : YUSUF BADE Mother's Name : KHURSHID

Marital Status : UnMarried Mother Tongue :


Place Of Birth : MORBA Gender : Female Date of Birth (DD/MM/YYYY) : 04/07/1989
Blood Group : Religion : Country of Citizenship : India
Height : Not Available Weight : Not Available Hemoglobin : Not Available
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Mumbai City Tehsil : Mumbai City/Town/Village :
Available
Address (House 60, FLOOR-3, PLOT-2, HABIB APARTMENT, NAMDEO UMAJI BHALINGE MARK,
Pin Code : 400067
no,street/area/suburb etc.) : SANTA GADGE MAHARAJA MANDAI, BYCUL
Contact details
Mobile Number 919767940300 Email ID: ASMABADE@YAHOO.CO.IN
2.Legal Reservation Information
Category Type : Open Category : GEN
Is Specially Abled? No
3.Social Information(Additional Inforamtion)

Paper Selected for:


Sem I [4E00141]
75101 - Childhood And Growing Up 75102 - Knowledge and Curriculum
75103 - Gender, School and Society UBEDSI.1.4 - Critical Understanding of ICT
UBEDSI.1.5 - Project Based Course 1
Sem II [4E00142]

47612 - Learning And Teaching 47613 - Educational Management


UBEDSII.2.2 - Pedagogy of School Subject I 47607 - Pedagogy of Teaching:Mathematics

Medium of Instruction : English


4.Guardian Information
Occupation of Guardian : Professional Annual Income of Guardian : 50000
5.Educational Details
Month Exam
Name of Board/University and Name of Certificate Mark
Name of Examination and Year Seat Out of CGPA %
State of University School/College No. Obtained
of Passing No.
MAHARASHTRA STATE
BOARD OF SECONDARY AND March
Std 10th -- -- 625.00 750.00 -- - -- 83.33
HIGHER SECONDARY 2004
EDUCATION,
MAHARASHTRA STATE
Std 12th 12Th BOARD OF SECONDARY AND February
-- -- 438.00 600.00 -- - -- 73.00
(Science) HIGHER SECONDARY 2006
EDUCATION,
Month Exam
Name of Board/University and Name of Certificate Mark
Name of Examination and Year Seat Out of CGPA %
State of University School/College No. Obtained
of Passing No.
Degree : BSC
COPUTER October
-- -- 429.00 800.00 -- - -- 53.63
SCIENCE(Bachelors) 2010
Degree
Degree : B.Sc.(With
Credits)-Regular- Passed -- -- - - -- - -- -
Rev16
SIDDHARTH
Degree : Bsc(Maths) University of COLLEGE OF ART
April 2019 3000047 6th 518.00 800.00 -- - -- 64.75
(Mathematics) Mumbai,Maharashtra SCIENCE
COMMERCE
Your Last Qualifying Exam: Bsc(Maths)
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.

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 :3729167 (BADE ASMA YUSUF) 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 Remarks / Particulars / Recommendations Signature and Date
Admission Clerk
Admission
Committee
Accountant/Cashier Cash Received: INR Receipt No.: Date:
Registrar/Office
Superintendent
Document printed on Wed Feb 17 2021 20:01:45 GMT+0530 (India Standard Time)

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy