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Office of
the
Deputy
Application Form No.: 155467 Application Version No. 0
Director Application Form Version Date:
of Application Form Printed On: 7/16/2010 7:48:11 PM
Educatio 7/16/2010 7:49:50 PM Application Form Version Updated By:
n, 155467
Mumbai
Region,
Mumbai
11th
Standard
Online
Admission
2010-11,
Mumbai
Region
Application
Form
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ऑनलाइन
पवेश पिकया
(F.Y.J.C)
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Personal Details, Type of Candidature and Board Details of Applicant:

Mothers
Full Name TAMBOLI SABA RAFIK SULTANA
Name

Gender Female Date of Birth 09-04-1995

Month & Year of March ,

Board SSC Seat No. A210237
Passing 2010

[School Code:3105032] SHARADASHRAM

10th School
Residence MMR VIDYAMANDIR GIRL'S HIGH SCHOOL,
Details
DADAR

School Ward 10th School Area

Address for Correspondance and Contact Details:

Mumbai G (South) & Residential Lower Parel-Anee Bezant

Zone Ward
South G (North) Area Road

Correspondance Address:- B-13 Rm-13,sir pochkhanwala road,worli police camp,mumbai 30,District:Mumbai

City,State:Maharashtra,Taluka:Mumbai,PinCode:400030
 9420344623
husentamboli@yahoo.co
Phone No Mobile No , Email Id
m
9730834767

Reservation Details:

Category OPEN Other Category Bifocal

1. Following applicants MUST visit their respective School Principals/Guidance Center with printout of
application form along with supporting documents for verification & approval
a. SSC board students of ‘Reserved Categories’ with or without claiming any ‘Special Reservation’
b. SSC board students of ‘Open Category’ but claiming any ‘Special Reservation’

c. All other boards’ (other than SSC) students

d. All boards’ (including SSC) students requesting any rectifications under grievances

2. All OMS and OMMR applicants MUST visit Guidance Center with printout of application form along with
supporting documents for verification & approval

Declaration:- I hereby declare that all the information furnished by me in this online application form is true,
complete and correct to the best of my knowledge and belief. I understand that entire information furnished by me
in this Online Application Form is final and binding on me. I further declare that in the 11 th standard Online
Admission Process, if any information furnished by me is found false or incorrect, I shall be liable for legal action by
rule.

Place: Principal's Signature:-

Applicant's Signature:-
Date: Principal's Name:-
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