9/2/2020 Document

Educational Trust's
(Reg. No.: E-25932)
SR. No.: 1

Junior Science College, Nerul

Tel : Mob. : , Email:

U-DISE NO: 12345567887

ADMISSION FORM DATE: 02/09/2020
College Index No :
F.Y.J.C (XI) SCIENCE
Pending Documents: Teacher Name & sign

• I am confirming my F.Y.J.C admission for Science stream at Pace Junior Science College, Nerul for academic year 2020-21.

• I, hereby declare that, the entries made by me in the Application Forms (both Govt. Online admission & Pace Junior Science
College, Nerul F.Y.J.C Application) are complete and true to the best of my knowledge and based on factual records.

• I am aware that if the information in my admission form is found wrong, then my admission in your esteemed Junior college
will be liable for cancellation.

• I shall abide by the rules and regulations of the college relating to the attendance of the Maharashtra State Board of
Secondary and Higher Secondary Education. I am aware that I will not be permitted to appear for college examination at the
end of the year if my attendance is less than 75% at the lecture/ Practicals / tutorials in each term separately.

• I shall abide by the rules and regulation of your esteemed Junior college relating to the attendance, discipline, academics,
extracurricular activities and promotion.

Signature of Parent/Guardian Signature of the Applicant

Online Admission Application No. / Login Id: : MU2020022

Last Name : First Name : Ashu Middle Name : Kumar

Student Contact No (Mobile) : Student Email Id : Name as per Std. X marksheet : Ashu
7896543210 ashu@gmail.com kumar
Name as per Aadhaar : ashu kumar Aadhaar No. : 321456789012 Date of Birth : 06/06/2002
Gender : Male Residential Addres : qwerty uiop asdf ghjkl zxcv nm
Pincode : 400058

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9/2/2020 Document

Educational Trust's
(Reg. No.: E-25932)
SR. No.: 2

Junior Science College, Nerul

Tel : Mob. : , Email:

Student's Additional Details

No. of Siblings : 2 Religion : Hindu Linguistic Minority : No
Caste and Category : SC Divyang : No Place of Birth : Pune
District : Pune State : Maharashtra Nationality : Indian
Mother Tongue : NA

Academic Record
Name of the school (appeared for Std. X. Exam): abc school
Address of the school (appeared for Std. X. Exam) : qsswidiwdji
Email Id of the school (appeared for Std. X. Exam) : abc@gmail.com
Contact No. of the school (appeared for Std. X. Exam) : 9876543210
Board : CBSE Medium of Instruction : English
Board Seat No./Unique Id/Roll No. : 3456 Total Marks (Out Of 500) : 450
Percentage (in two decimal places) :90.00%

Particular about my parent (Father)

Full Name:fgh Contact No. (Mobile) : 7653426432
Email Id : fge@gmai.com Occupation : Homemaker

Particular about my parent (Mother)

Full Name: dege Contact No. (Mobile) : 8765432109
Email Id : wdd@gmail.com Occupation : Homemaker

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9/2/2020 Document

Educational Trust's
(Reg. No.: E-25932)
SR. No.: 3

Junior Science College, Nerul

Tel : Mob. : , Email:

Particular about my Guardian

Full Name: NA Contact No. (Mobile) : 9876543120
Relation : NA
Office Address : NA

Subject Offered at FYJC

Compulsory Subjects: : Bifocal Subjects:Electrical Maintenance (E.M.)

English

Environment Education

Health and Physical Education

Physics

Chemistry

Mathematics & Statistics

Terms and Condition

• College reserves it's rights to make any alteration in it's program or fee structure without any prior notice to anybody.

• College fee will be non- refundable in case the cancellation is done after all F.Y.J.C online admission 2020 rounds are over.

✓ I hereby agree to the above mentioned.

Uploaded Documents
- Leaving Certificate (Transfer Certificate)
- Marksheet
- Online Admission Form (Part-1)
- Online Admission Form (Part-2)
- Aadhaar Card
- Caste/Reservation (if applicable)
- Photograph

Date: -- / -- / ----
Signature of the Teacher Incharge

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