SHREE CHANAKYA EDUCATION SOCIETY'S

Indira College of Commerce And Science

Dhruv, 89/2A, New Pune-Mumbai Highway, Tathwade, Pune-411033

ADMISSION FORM (M.Sc.(Comp.Sci.) 2020-21)

21 - 22
Form No. M.Sc. (Comp.Sci)A-1960043

Personal Information
Full Name DHIRAJ RAJENDRA
JARAD
DOB OCT 23,1999 Gender MALE
Email Id dhirajjarad99@gmail.co Mother's Name NIRMALA
m
State of Domicile MAHARASHTRA Phone No -
Applicant Registered 7620172077 Religion HINDU
Mobile Number
Caste HINDU Sub Cast MARATHA
Mother Tongue MARATHI Admission Quota MAHARASHTRA (MH)
Type:
Reserve Category: OPEN Residence Address JARADWADI
Permanent Address JARADWADI
Country INDIA State MAHARASHTRA
City Pin 413102
BARAMATI
Taluka District PUNE
BARAMATI
Adhaar Card Number 451509856135
Blood group AB+
Parent Details
Parent Information Father's Details Mother's Details
Name RAJENDRA MAHADEO JARAD NIRMALA RAJENDRA JARAD
Email ID : Dhirajjarad9527@gmail.com dhirajjarad9527@gmail.com
Mobile No. : 7666282856 7666282856
Address : JARADWADI BARAMATI BARAMATI BARAMATI 413102
Pin Code : 413102
Profession : AGRICULTURE HOUSEWIFE
Annual Income of the Family : 40000
Guardian Details
Guardian Full Name RAJENDRA MAHADEO JARAD
Email ID : Mobile No. : 7666282856
Address : AT-JARADWADI, POST - Age : 48
UNDAWADI K.P.
Pin Code : 413102 Relation : FATHER
Graduation Details University Name : Savitribai Phule Pune
University, Pune
Grand Total / Out of 1279 / 1900 Percentage ( % ) 67.32
Degree Name B.SC. (COMP. SCI)
Qualifying Status COMPLETED Year of Passing 2020
Principal subject / Class 851 / 1200 Class Percentage (%) 70.92
total
Documents attached
1 HSC MARKSHEET
2 GRADUATION MARKSHEET
3 ORIGINAL LEAVING CERTIFICATE
4 DOMICILE CERTIFICATE
5 AADHAR CARD
6 AADHAR CARD
7 AADHAR CARD
Declaration to be signed by the Applicant:
I Dhiraj Rajendra Jarad hereby agree, if admitted, to confirm to the rules and regulations at present in force, or that may be
made for the good governance of the college, undertake that as long as I am a student of this college, I will not interfere with its
orderly governance and discipline. I further declare that, I shall not take part in any movement like to be subversive of law and
order.<br>
I hereby submit, to the disciplinary jurisdiction of the Vice-Chancellor and the other officers and authorities of the University / and
the authorities of college and shall observe and abide by the rules made by the Vice-Chancellor, Savitribai Phule Pune University
in that behalf and also by the rules made by the principal of the college.<br>
I have carefully noted the rules and procedures of admission as given in the prospectus which I am required to follow for getting
admission to the applied course and shall in matter of interpretation accept the decision, given by the Principal in this respect as
final and binding. I shall attend minimum 80 percent of the classes for each course as per rules of the Savitribai Phule Pune
University failing to which I shall be solely responsible for the consequences. I have carefully read all the information, rules and
regulations mentioned in the college prospectus and undertake to abide by them.<br>
I hereby declare that all the particulars stated below by me are true and correct.<br>
List of self attested copy of documents & original for verification to be submitted at the time of admission.<br>
1. Printed copy of Filled Online Application Form, Form Fees Receipt<br>
2. Statement of marks of Graduation examination<br>
3. School Leaving Certificate / Transfer Certificate<br>
4. Caste Certificate, Caste Validity and Non Creamy Layer Certificate (if belonging to backward classes)<br>
5. Migration Certificate (if belonging to other than Pune Board/University)<br>
6. Gap Certificate (if there is any gap in education)<br>
7. 2 Passport Size Photograph<br>
8. Xerox Copy of Aadhar Card (not Mandatory)<br>

PLACE :

Date : Jan 08,2021

Signature of Candidate