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Bhavans College OR Bhartiya Vidya Bhavans M. M. College of Arts, N.M. Institute of Science and H.R.J. Application
College of Commerce (115)

Munshi Nagar.
Andheri
No :

University of Mumbai
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)

1498060

Academic Year: 2021-2022 Regular

APPLICATION FORM

Course Applied for : B.Sc. (Biotechnology)(Autonomous)(with Credits) - Regular - CBCS - F.Y.B.Sc. PRN:
(Biotechnology)(Autonomous) Sem I 
(-)

Application Date : 13/08/2021 Payment Category :

1.Personal Information
Candidate's Name(Regional) : పిగిలి అఖిల్ కుమార్
PIGILI AKHIL KUMAR
Candidate's Name as printed on
[*This name will appear on all University

Mark sheet :
records/documents]
Father's/Husband's Name : SRINIVASARAO PIGILI Mother's Name : SUBHASHINI
Marital Status : UnMarried Mother Tongue : Telugu
Place Of Birth : Ongole Gender : Male Date of Birth (DD/MM/YYYY) : 18/01/2004
Blood Group : Religion : Hindu Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Andhra Pradesh
Address For Correspondence :
City/Town/Village :
State : Andhra Pradesh District : Prakasam Tehsil : Ongole Location Area : Urban
Ongole
Address (House
no,street/area/suburb 37-1-1-14 ANNAVARAPADU 4 LINE ONGOLE Pin Code : 523001
etc.) :
Permanent Address :
City/Town/Village :
State : Andhra Pradesh District : Prakasam Tehsil : Ongole Location Area : Urban
Ongole
Address : 37-1-1-14 ANNAVARAPADU 4 LINE ONGOLE Pin Code : 523001
Contact details
Mobile
8074781941 Email ID: srinupigili@gmail.com
Number
2.Legal Reservation Information
Category Type :
Category : OBC Sub Category : Kshatriya
Reserved
Is Specially Abled? No
3.Social Information(Additional Inforamtion)
Ward of Primary Teacher
Paper Selected for:
Sem I
BSC BT 1.1 - Paper 1 BSC BT 1.2 - Paper 2
BSC BT 1.3 - Paper 3 BSC BT 1.4 - Paper 4
Sem II

BSC BT 2.1 - Paper 1 BSC BT 2.2 - Paper 2

BSC BT 2.3 - Paper 3 BSC BT 2.4 - Paper 4
Medium of Instruction : English
4.Guardian Information
Occupation of Guardian : Farmer Annual Income of Guardian : 0
5.Educational Details
Month
Name of
Name of Name of and Year Exam Seat Certificate Mark
Board/University and Out of CGPA %
Examination School/College of No. No. Obtained
State of University
Passing
ANDRA PRADESH BOARD
GUNTUR
OF SECONDARY 9.3
-
Std 10th OXFORD EM May 2019 1916101247 -- - - -
EDUCATION,Andhra A
HIGH SCHOOL
Pradesh
ANDRA PRADESH BOARD
SRI CHAITANYA
Std 12th OF INTERMEDIATE
JUNIOR May 2021 2107211333 -- 744.00 1000.00 --
-
-- 74.40
Science EDUCATION,Andhra
COLLEGE
Pradesh
Your Last Qualifying Exam: HSC/Std 12th [Science]
7.Other Information
Would you like to apply for Hostel accommodation required NA
Required Documents and Certificates Section:
Passing Certificate of Std 12th / Statement of Marks of Std 12th OR Original Passing Certificate /Statement of Marks of Last
Qualifying Exam like degree,diploma,etc.

Certificate of Caste with Category.

DECLARATION
I hereby declare that all the information furnished by me in this application form
is true, complete and correct to the best of my
knowledge and belief. I do understand
that I need to obtain and produce all the required documents.
I
Application No :1498060
(PIGILI AKHIL KUMAR)
admit to having understood what constitutes ragging and sexual harassment. I have
read the guidelines
related to the same. I hereby affirm that if found guilty of
ragging or sexual harassment I am liable for punishment according to
the university
regulations.

Place : Date  :
( Signature of the Candidate )
For College/Institute/Study Center Use Only
Designation Signature and
Remarks / Particulars / Recommendations
Date
Admission Clerk
Admission
Committee
Accountant/Cashier Cash Received: INR Receipt No.: Date:
Registrar/Office
Superintendent
Document printed on Fri Aug 13 2021 23:24:53 GMT+0530 (India Standard Time)