Bharatiya VidyaBhavan`s

Sardar Patel College of Engineering

Government Aided Autonomous Institute Under Mumbai University
Munshi Nagar, Andheri (West), Mumbai- 400058

Admission Form for First/ Second/ Third/ Fourth Year

B. Tech (Civil, Mechnical, Electrical) 2019-20

Personal Details

Registration ID C1810090

Programme B.Tech

Name SAPARIA JASH PARESH

Year SY Branch CIVIL

Contact No. 9594989213 Alt. Contact No. 9867278799

Email ID superjash123@gmail.com Gender Male

Address B-402,laxmi residency,above PNB,wagle estate,thane west-400604

Correspondance Address B-402,laxmi residency,above PNB,wagle estate,thane west-400604

Date of Birth 2000-03-29 Place of Birth mumbai

Marital Status Un - Married Blood Group O+

Aadhar Card No. 786680778205 Seat Type MS

Religion Hindu Category OBC

Sub Caste gurjar kadia(45) Nationality indian

Physically Handicapped No Defence Type No

Parents / Guardian Details

Fathers Details

Father Name paresh sapariya Mobile No. 9867278799

Email ID pareshsapariya76@gmail.com Designation/Occupation business

Annual Income 4,31,661 Name of Organization NA

Office Address A-5,surya darshan tower,thane west-400604

Pin Code 400604 Phone No. NA

Mothers Details

Mother Name jagruti sapariya Mobile No. 9594989211

Email ID jagrutisapariya@gmail.com Designation/Occupation housewife

Annual Income NA Name of Organization NA

Office Address NA

Pin Code 400604 Phone No. NA

Guardian Details

Guardian Name NA Mobile No. NA

Email ID NA Designation/Occupation NA

Annual Income NA Name of Organization NA

Office Address NA

Pin Code NA Phone No. NA

Academic Details

SSC Detail

Month of Passing March Year of Passing 2016

School Name lokmanya tilak english high school

School Address near hira mongi hospital,V.P road,mulund west-400080

Name of Board maharashtra state board of secondary and higher se

Marks Obtained 467 Total Marks 500

Percentage 93.40

HSC Details

Month of Passing February Year of Passing 2018

School Name friends junior college

School Address lbs marg,mulund west,mumbai-400080

Name of Board maharashtra state board of secondary and higher se

Percentage 75.85 Candidature Type Type A

Vocational Type computer science

Physics Chemistry Mathematics PCM Vocational Grand Total

Marks Obtained 72 64 79 215 162 493

Total Marks 100 100 100 300 200 650

Diploma Details

Month of Passing NA Year of Passing NA

School Name NA

School Address NA

Name of Board NA Roll No. NA

Marks Obtained NA Total Marks NA

Entrance Exam Details

Entrance Exam Name Roll No. Physics Chemistry Mathematics Total Percentage

Marks CET MM1149053 26 24 50 100 NA

Entrance Exam Name Roll No. Physics Chemistry Mathematics Total Percentage

Marks JEE 24215847 -4 22 34 52 NA

Entrance Exam Name Roll No. Physics Chemistry Mathematics Total Percentage

Marks AIEEE NA NA NA NA NA NA1

Merit No. 17395 Merit Marks 100

B. Tech Details

Class Registration No. Month of Passing Year of Passing CPI Result

F.Y.B. Tech C1810090 july 2019 6.83 PASS

S.Y.B. Tech NA NA NA NA NA

T.Y.B. Tech NA NA NA NA NA

Declaration To Be signed by The Applicant And To be Endorsed By The Father Or Guardian

UNDERTAKING

I _________________________________ hereby declare that I have taken admission in the F.Y/ S.Y/T.Y./Final Year
B.Tech. (Civil, Mechanical, Electrical) Engineering Degree Course in Sardar Patel College of Engineering on my own.

a. I have read all the rules of admission for the year 2019-20 & undertake to abide by the same.

b. The information given by me in my application is true to be the best of knowledge & belief.

c. I have not been debarred from appearing at any examination held by the Government or any Statutory Body in india.

d. I hereby agreed to confirm to any Rules Act & Laws enforced by Government & I hereby undertake that so long as I
remain student of college,I will do nothing either inside r out of the college which my result in disciplinary action against the
under the rules of onduct & discipline.
e. I fully understand that the Principal of the Sardar Ptel College of Engineering, Andheri (W), Mumbai will have fully authority
to expel me from the college of any infringement of rules of conduct & discipline.
f. I am fully aware that there is likely to be a change in the fees structure & I understand to pay fees whatsoever, approved by
competent authority..
g. I am fully aware that I will not be allowed to appear for the examination if I do not attend minimum 75% class in theory,
practical, drawing etc., I am also aware that I will not allowed to appear for the examination if I fail to submit satisfactory all the ,
assignment job, journal, drawing, reports as specified by the university within stipulated time limit.

Following Original Documents are retained with college :

SSC Marksheet HSC Marksheet / Diploma Final Marksheet

Caste Certificate Caste Validity

Registration Date : 2019-07-29 23:07:05 Signature of Student

Office Use Only

Registration ID C1810090

Programme B.Tech

Name SAPARIA JASH PARESH

Year SY

Branch CIVIL

Following Original Documents are retained with college :

SSC Marksheet
HSC Marksheet / Diploma Final Marksheet
Caste Certificate
Caste Validity

Registration Date : 2019-07-29 23:07:05

Verified by : Date :