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B. K. Birla College of Arts, Science & Commerce, Kalyan

Disha Mhatre is applying for admission to Class 12 (Accounts and Auditing) at B. K. Birla College of Arts, Science & Commerce in Kalyan. She provides her personal details like name, gender, date of birth, address, contact information, parent and guardian details. She declares that she has read the college rules and regulations and will abide by them. She gives consent for her contact details to be used for educational communication. She acknowledges requirements around attendance, other employment or enrollments, conduct, and documents required for admission.

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prashant mhatre
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365 views

B. K. Birla College of Arts, Science & Commerce, Kalyan

Disha Mhatre is applying for admission to Class 12 (Accounts and Auditing) at B. K. Birla College of Arts, Science & Commerce in Kalyan. She provides her personal details like name, gender, date of birth, address, contact information, parent and guardian details. She declares that she has read the college rules and regulations and will abide by them. She gives consent for her contact details to be used for educational communication. She acknowledges requirements around attendance, other employment or enrollments, conduct, and documents required for admission.

Uploaded by

prashant mhatre
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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B. K.

BIRLA COLLEGE
OF ARTS, SCIENCE & COMMERCE, KALYAN
Conducted by Kalyan Citizen's Education Society

UDISE No: 27210600314 Index No: J 16.17.008


Application for Admission to XII MCVC (ACCOUNTS & AUDITING) -

Applicant's Personal Details :

Name of the Student : Surname First name Father's name Mother's Name

MHATRE DISHA ANANTA SHASHIKALA

Student Name(MARATHI) ददशश अननतश ममशतत


Gender : FEMALE Aadhaar card Number : 297716024057

Marital Status : UNMARRIED Blood Group : A+

Date of Birth : 10/12/2005 Place Of Birth : KALYAN

Birth Taluka : kalyan Birth District : thane

Birth State : maharastra Birth Country :

Nationality : INDIAN Voter Id :

Religion : HINDU Caste Category : OBC


Caste : Sub Caste : HINDU AGRI

Mother Tongue : MARATHI Physically Challenged :


Stream : MCVC U-Dise of Previous Class :
Student's Saral Id :

Address for Correspondence(As per Aadhar Card):

Address : 176,GAURIPADA GOAN, MILIND NAGAR ROAD ,BEHIND BIRLA COLLEGE ,NEAR
HANUMAN MANDIR KALYAN WEST

City/Town/Village : THANE District : Thane

State : Maharashtra Pincode : 421301

Residential Area: Urban/Rural

Permanent/Native Address :

Address : 176,GAURIPADA GOAN, MILIND NAGAR ROAD ,BEHIND BIRLA COLLEGE ,NEAR
HANUMAN MANDIR KALYAN WEST

City/Town/Village : THANE District : Thane

State : Maharashtra Pincode : 421301

Contact Details :

Student's Phone No: 9220889587 Student's Email Id: mhatredisha703@gmail.com

Parent's Phone No: 9224448857 Parent's Email Id:


Guardian's Phone No: 9.22445e+009 Guardian's Email Id:

Parent's Details:

Name : ANANTA

Office Address :

Occupation : FARMER Annual Income(Rs.) : 98,000.00


Sr.No. Subject Name Subject Type

Group Name :

Declaration by Student

1.I hereby declare that I have read all the rules and regulations framed by the college authorities as given in college
prospectus, which are presently in force.
2.I hereby declare and undertake to abide by all the mentioned rules and regulations and hereby agree, if admitted,
to confirm to them and to such other rules as may hereafter be made for the smooth functioning of the college
3.I may not be granted terms or allowed to appear for the College/University Examination if my attendance in
lectures and tutorials/practicals falls short of 75 %.
4.I may not be granted any concession in any matter, if I take up any employment during the course of my studies.
5.I hereby declare that I shall show satisfactory progress and maintain good conduct.
6.I hereby declare that I have not registered my name at any other institution for any other full time course.
7.I hereby declare that the information filled in by me in this form is accurate and true to the best of my knowledge.
I will be responsible for any discrepancy,arising out of the form signed by me and I undertake that, in absence of
any document the final admission will not be granted and/or admission will stand cancelled.
8.I WILL DISPLAY MY IDENTITY CARD PROMINENTLY IN THE COLLEGE PREMISES.
9.I have given my and my parents most recent contact details(Phone, Email). In case of any change I undertake to
inform college accordingly.
10.I hereby give my consent for use of my contact details for educational communication.
11.I am aware that as per University Circular No.SW/42 of 2015 dtd. 29th Oct. 2015, I am compulsorily required to
give and undertaking on www.antiragging.in & www.amanmovement.org
12.I will get myself enrolled for Voter ID card when i would turn 18 Years of age.
13.I am aware that if eligible for Scholarship/Freeship scheme of Social Welfare Department then I must complete
all the formalities in time. If I fail to do so then I undertake to pay full fees of course by end of October of the
Current Academic year.
14.I have read eligibility conditions of University of Mumbai for my course. My admission will be confirmed subject
to confirmation from University of Mumbai.

Date : 24/08/2022

Signature of the Student

Declaration by Guardian / Parent

I __________________________________, have permitted my son/daughter/ward to join your college. The


information supplied by him/her is correct to the best of my knowledge. I have acquainted myself with the rules and
fees, dues of my son/daughter/ward and to see that he/she observes, the said rules in totality. I hereby give my
consent for use of my contact details for educational communication.

Date : 24/08/2022
Signature of the Guardian/Parent

Sr. No. Uploaded Document Information


1 AADHAR CARD

2 CASTE/CASTE VALIDITY CERTIFICATE

3 CLASS X MARKSHEET

4 CLASS XI MARKSHEET

Note:
Attach the photocopy of the following documents and certificates:
1. For F.Y.J.C.(XI) Admission- Marksheet of SSC.
2. For S.Y.J.C.(XII) Admission- Marksheet of SSC & F.Y.J.C.(XI)
5. Caste Certificate & Caste Validity Certificate(if any).
6. Address Proof(Aadhar Card/ Passport/ Electricity Bill/ Telephone Bill).

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