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Department of Marathi, Churchgate (376)

1, Nathibai Thakersey Road, New Marine Line,

Mumbai
Application No :

Shreemati Nathibai Damodar Thackersey Women's University

1, Nathibai Thackersey Road, New Marine Lines, Mumbai-400020, Maharashtra (India)

67853

Academic Year: 2022-2023 Regular

APPLICATION FORM

Course Applied for : M.A. Marathi(with Credits) - Regular - Revised 2020 - Part I M.A. Marathi Sem I 
(-) PRN:2019016100060046
Application Date : 01/10/2022 Applying for scholarship? No
Exam Center Name [Code] : - [-]
1.Personal Information
Candidate's Name(Regional) :
MORE AKANKSHA SANTOSH

Candidate's Name as printed on

[*This name will appear on all University

School leaving/Passing Certificate :

records/documents]
Father's/Husband's Name : SANTOSH Mother's Name : VEENA
Marital Status : UnMarried Mother Tongue :
Place Of Birth : Mumbai Gender : Female Date of Birth (DD/MM/YYYY) : 07/03/2001
Blood Group : Religion : Country of Citizenship : India
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
no,street/area/suburb A Wing 203 Govindwadi Seth Chawl Andheri East Pin Code : 400093
etc.) :
Contact details
Mobile
9082277919 Email ID: akankshamore39@gmail.com
Number
2.Legal Reservation Information
Category Type :
Category : GEN
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
104501 - sahityavichar -I 104502 - Bhasha Vigyan
104503 - Adbhunik Marathi Vangmayachya Etihas 104601 - Marathi Loksahitya
104701 - Marathi Stree Sahitya
Sem II

204501 - Sahityavichar –II 204502 - Sanshodhanshastra

204503 - Adbhunik Marathi Vangmayacha Etihas (Kathatma 204601 - Marathi Vaicharik Sahitya
Sahitya) 204702 - Sahityache Adhypan

Medium of Instruction : Marathi

4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 120000
5.Educational Details
Month Exam
Name of Name of Board/University Name of Certificate Mark Out
and Year Seat CGPA %
Examination and State of University School/College No. Obtained Of
of Passing No.
MAHARASHTRA STATE
BOARD OF SECONDARY AND March
Std 10th -- -- 279.00 500.00 --
-
-- 55.80
HIGHER SECONDARY 2016
EDUCATION,
MAHARASHTRA STATE
Std 12th 12Th BOARD OF SECONDARY AND February
-- -- 321.00 650.00 --
-
-- 49.38
(MCVC) HIGHER SECONDARY 2018
EDUCATION,
MAHARASHTRA STATE
BOARD OF SECONDARY AND March
Std 10th -- -- 279.00 500.00 --
-
-- 55.80
HIGHER SECONDARY 2016
EDUCATION,
MAHARASHTRA STATE
Std 12th 12Th BOARD OF SECONDARY AND February
-- -- 321.00 650.00 --
-
-- 49.38
(MCVC) HIGHER SECONDARY 2018
EDUCATION,
Degree : B.A.
(With Credits)-
Passed -- -- - - --
-
-- -
Regular-Revised
2014
Your Last Qualifying Exam: B.A.(With Credits)-Regular-Revised 2014
7.Other Information
Would you like to apply for Hostel accommodation required NA
Required Documents and Certificates Section:
last qualifying exam(HSC/Degree/Diploma)

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 :67853
(MORE AKANKSHA SANTOSH)
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 Sat Oct 01 2022 19:51:13 GMT+0530 (India Standard Time)