Programme - B.A.(Advertising Online Application No. (Univ.

) - 399152 Application Number - 32122

Communication Design)
Chikitsak Samuha's
S. S. & L. S. Patkar College of Arts & Science And
V. P. Varde College of Commerce & Economics
S. V. Road, Goregaon (West), Mumbai - 400062.
Personal Details :
Name : Miss BHOITE MAYURI TANAJI Mother's Name : KAUSHALYA
Gender : Female Date of Birth : 06/06/2001 Religion : Hindu
Cast Category : Open Category for Admission : Open
Contact Details :
Address : C/501, Omkar Jaldhara, Santosh Nagar, Goregaon(East)
City : Mumbai State : Maharashtra Pin Code : 400065
Email : vengurlekarrahul@yahoo.com Contact No. : 9594097424 / 9082277927
Academic Details :
S.S.C. Details : Marks Obtained : 360 / 500 Converted Marks : 396.00 / 550
H.S.C. Details : Marks Obtained : 357 / 650 Converted Marks : 329.54 / 600
College Name : Sathaye College
Stream : ARTS
Board : H.S.C.(MAHARASTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION)
Year of Passing : February/2018 Number of Attempts : 1
Other Details : --
Applicants are required to attach Certified True Copies of the following documents :
1. S.S.C. Passing 2. H.S.C. Marksheet 3. H.S.C. Leaving
4. Online Application (Univ.)
Declaration :
I confirm that all the information given in this application form is correct.

Date : ___ / ___ / ____ Student's Signature

(Miss BHOITE MAYURI TANAJI )

Programme - B.A.(Advertising
Application Number - 32122
Communication Design) ACKNOWLEDGEMENT
Chikitsak Samuha's
S. S. & L. S. Patkar College of Arts & Science And V. P. Varde College of Commerce & Economics
S. V. Road, Goregaon (West), Mumbai - 400062.
Received application form for admission to F.Y. (B.A.(Advertising Communication Design)) Class for the academic
year 2019-20 from :
Miss BHOITE MAYURI TANAJI
Cast Category : Open Category for Admission : Open

Date : ___ / ___ / ____

Receiver’s Signature
Note -
Admission form will be issued only after the confirmation of the admission as per merit list displayed on the Notice
Board as per schedule.