5/16/2019 Rizvi College - Online Registration Form

REGISTRATION DATE: ADMISSION FORM: FORM NO.: APPLICATION NO.:

16/05/2019 2019 | 2019 - 2020 1900001218 835

Rizvi Education Society

Rizvi College Of Arts, Science & Commerce
Rizvi Education Complex, off. Carter Road, Bandra (West), Mumbai -
400050
Email: principal.asc@rizvicollege.edu.in Contact No: 2226004248
SY JC Commerce

PERSONAL INFORMATION
SURNAME/LASTNAME: FIRST NAME: MOHAMMAD ZAFAR FATHER NAME: NAZIR HUSAIN
SAYED
MOTHER NAME: ZAINAB MIDDLE NAME: - DATE OF BIRTH: 01/11/2002
MOBILE NO: 9664834487 EMAIL ID: ZAFARSAY111@GMAIL.COM ADMISSION CATEGORY: Open
GENDER: Male AADHAR CARD NO: 231613121069 RELIGION: Islam
CATEGORY: General CASTE: Open     SUB-CASTE: SUNNI NATIONALITY: INDIAN
MOTHER TONGUE: HINDI MARITAL STATUS: UnMarried BLOOD GROUP: O+
NAME AS PER LAST QUALIFYING EXAMINATION MARKSHEET:
SAYED MOHAMMAD ZAFAR NAZIR HUSAIN ZAINAB
FULL NAME IN [DEVNAGRI SCRIPT]: मुह द ज़फर ना ज़र सैन ज़ैनब
CORRESPONDENCE R. C. MARG, CHEMBUR, AZIZ BAUG, SHAHAJI NAGAR, KHADI MACHINE,
ADDRESS: CHEMBUR, MUMBAI
CITY: MUMBAI PINCODE: 400074 COUNTRY: INDIA
IS PERMANENT ADDRESS SAME AS CORRESPONDENCE ADDRESS: Yes

PERMANENT ADDRESS: R. C. MARG, CHEMBUR, AZIZ BAUG, SHAHAJI NAGAR, KHADI MACHINE,
CHEMBUR, MUMBAI
CITY: MUMBAI PINCODE: 400074 COUNTRY: INDIA

PROGRAM/CAMPUS
LEVEL: After 10th Class
BRANCH: JC COURSE: Junior College - (JC) BATCH: Commerce ACADEMIC YEAR: SY
OPTED SUBJECTS
GROUP
Compulsory
English
Economics
Oganization of Commerce & Management
Bookkeeping & Accountancy
Environmental Studies
Optional
Hindi
Optional
Secreterial Practice

PREVIOUS ACADEMIC RECORD

Class 10 (X)

BOARD: SSC OTHER BOARD NAME: - BOARD ROLL NO: A345740

PASSING YEAR: 2018 PASSING MONTH: March NUMBER OF ATTEMPTS: 1

PREVIOUS ATTEMPT YEAR: - PREVIOUS ATTEMPT MEDIUM OF INSTRUCTIONS:

MONTH: - ENGLISH

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5/16/2019 Rizvi College - Online Registration Form

INSTITUTE NAME: CITY: MUMBAI PINCODE/ZIP CODE: 400074

ST.SEBASTAIN HIGH SCHOOL
OVERALL GRADE: PASS TOTAL MARKS OBTAIN: 398 OVERALL TOTAL MARKS: 500
AGGREGATE PERCENTAGE: 79.600 % UDISE NO: 27220800235
MARKING SYSTEM: Marks
# Subject Name Marks Obtained Maximum Marks
1 SOCIAL SCIENCE 86 100

CLASS 11 (XI)

BATCH/STREAM: BOARD: HSC OTHER BOARD NAME: -

COMMERCE
BOARD ROLL NO: 436 PASSING YEAR: 2019 PASSING MONTH: April

NUMBER OF ATTEMPTS: 1 PREVIOUS ATTEMPT YEAR: - PREVIOUS ATTEMPT

MONTH: -
MEDIUM OF INSTITUTE NAME: CITY: MUMBAI
INSTRUCTIONS:ENGLISH RIZVI COLLEGE OF ARTS , SCIENCE AND COMMERCE
PINCODE/ZIP CODE: OVERALL GRADE: PASS TOTAL MARKS OBTAIN:
400050 399
OVERALL TOTAL MARKS: AGGREGATE PERCENTAGE: 61.385 % UDISE NO:
650 27220200502
MARKING SYSTEM: Marks
# Subject Name Marks Obtained Maximum Marks
1 ENGLISH 64 100

FAMILY INFORMATION

FATHER DETAILS:

FULL NAME: SAYED NAZIR HUSAIN

AGE: 43 EMAIL: MOBILE NO: 9870763693 QUALIFICATION:

SAYEDNAZIRHUSAIN@GMAIL.COM Graduate
PROFESSION: ORGANIZATION: DESIGNATION: TOTAL INCOME:
SERVICE CARGO SERVICE CENTRE SR.CARGO OFFICER 300000
COUNTRY: INDIA

MOTHER DETAILS:

FULL NAME: SAYED ZAINAB NAZIR

AGE: 35 EMAIL: MOBILE NO.: QUALIFICATION:

ZAFSAY111@GMAIL.COM 9664834487 High School
PROFESSION: ORGANIZATION: - DESIGNATION: - TOTAL INCOME: -
HOUSEWIFE
COUNTRY: INDIA

SIBLINGS DETAILS:

Sr.No No Of Full Name Institute Name Admission No/GR. Class Study

Siblings No In

1 1 SAYED MOHAMMAD ST.SEBASTAIN HIGH 9TH

ANAS SCHOOL

2 2 SAYED MOHAMMAD ST.SEBASTAIN HIGH 3RD

JUNAID SCHOOL

3 3 AFSHEEN SAYED NOT

STUDYING

DOCUMENT UPLOADED
Aadhar Card
XIth Marksheet
Xth Marksheet

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5/16/2019 Rizvi College - Online Registration Form

UNDERTAKING BY THE APPLICANT AND PARENT/GUARDIAN

1.I/We have permitted my/our ward to join Rizvi College of Arts,Science & Commerce in the above
mentioned class/course.
2.I am/we are aware that, as per H.S.C. Board/University of Mumbai - Rules and Regulations, 75%
attendance in lectures, tutorials, practicals in each term/semester is compulsory. If my ward fails to
achieve the required attendance, the college authorities shall not accept his/her examination
form/shall not Issue the Hall Ticket/shall not allow him/her to appear in the 1st/2nd
term/Semester/Annual Examination.
3.I/We further,assure you of my wards good and orderly conduct as a student of this College.My
ward will not defame or be a cause of damage to the name of the College and any College
property.If found guilty, I /my ward will abide by the decisions of the Discipline Committee,Principal
and Management of Rizvi Education Society.
4.The information furnished in this form are true and conceals nothing.If found incorrect, my wards
admission will stand cancelled and I/we/my ward will not have any claim for the same.
 
 
Signature of Parent/Guardian                                                                                                 Signature of Student                     
                                                   
Office Use Only     
Tick where ever applicable
Documents Attached Fees Collection Details
Original Xerox
1. Marksheet     Receipt No:
2. Passing Certificate     Date:
3. Leaving / Tranference Certificate     DD No & Date:
4. Migration Certificate     DD Bank:
5. No Objection Certificate     Roll No/Div:

6. Provisional Eligibility Certificate  

   
 
7. Certificate of Caste with Category     Accountant/Clerk Signature
8. Certificate of Physically Challenged      
9. Residential Proof      
Checked and found all entries correct
and documents attached  
     
Signature of verifying person with Principal s Signature
date
 
 
 
 
 
 
 
 
 
 
 
 
 

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