Shri Vile Parle Kelavani Mandal's

MITHIBAI COLLEGE OF ARTS, CHAUHAN INSTITUTE OF SCIENCE &

AMRUTBEN JIVANLAL COLLEGE OF COMMERCE AND ECONOMICS
NARSEE MONJEE COLLEGE OF COMMERCE & ECONOMICS
USHA PRAVIN GANDHI COLLEGE OF ARTS, SCIENCE & COMMERCE
(AFFILIATED TO THE UNIVERSITY OF MUMBAI)
Tel. :- MITHIBAI : 42339000/01 NM: 42338000/01 UPG : 42332041/42
Application No.
Academic Year : 2021 - 22

Program Applied for : BCOM(Hons.):Bachelor of Commerce Honours

Category : Open
HSC/Equi. Stream : HSC Regular HSC Stream : COMMERCE
12TH / Equiv. Exam Passing Country* : India
Applicant Status * : Passed in One attempt Passed in more than one attempts

MITHIBAI COLLEGE OF ARTS, CHAUHAN INSTITUTE OF

Preference 1: SCIENCE & AMRUTBENJIVANLAL COLLEGE OF COMMERCE Univ. Application No. : 672237

DRAFT
Preference 2: Narsee Monjee College of Commerce & Economics (Autonomous) Univ. Application No. : 674304

State the total marks obtained of all the subjects

Marks Obtained at HSC/Equiv. Exam* 447 Out of 600 Marks 74.5 %

Personal Details : ( Full Name as printed on XII Marksheet )

Salutation* Last Name* First Name* Father's / Middle Name* Mother's Name*
Mr MISHRA OM KANTIMOHAN MANDAKINI

Gender
Nationality
Blood Group
Religion
Social Class
COPY
Marital Status
:
:
:
:
:
:
Male
Indian
O+
Hindu
General Category (GN)
Single
Date of Birth (DD.MM.YYYY)
Place of Birth
Aadhar No.
Mother tongue :
Caste
Disability
:
:

:
:
MUMBAI
:

5280XXXX89
HINDI
BRAHMAN
None
31.08.2002

Local Address for Correspondence :

Address Line 1 : F-10 BOLENATH SOCIETY Address Line 2 : AKURLI ROAD KANDIVALI EAST
GOKULNAGAR , City : MUMBAI
Address Line 3 : NEAR VINAY TOWER State : Maharashtra
Country : India E - mail ID : mishraom2031@gmail.com
Pincode : 400101 Mobile No. : 8291147404
Nearest Railway Station : KANDIVALI

Permanent Address :
Address Line 1 : F-10 BOLENATH SOCIETY Address Line 2 : AKURLI ROAD KANDIVALI EAST
GOKULNAGAR , City : MUMBAI
Address Line 3 : NEAR VINAY TOWER State : Maharashtra
Country : India Nearest Railway Station : KANDIVALI
Pincode : 400101

Page 1 of 2 User: OMMISHRA123 Application No.

Educational Details
Month & Year Marks Marks
Exam Board Seat No. % Name of Institute Address of Institute
of Passing Obtained Out of
SHARADA GYAN
PEETH
X ICSE 05 2019 6886801 373 500 74.6 MALAD EAST
INTERNATIONAL
SCHOOL
THAKUR COLLEGE OF
XII /
2021 M257493 447 600 74.5 SCIENCE AND THAKUR VILLAGE
Parents HSC
Equiv. Details 08
COMMERCE
Father's Details Mother's Details
First Name : KANTIMOHAN First Name : MANDAKINI
Middle Name : DEVNARAYAN Middle Name :
Last Name : MISHRA Last Name :
Occupation : Business Occupation :
Mobile No. : 8291147404 Mobile No. :
E - Mail ID : MISHRAOM910@GMAIL.COM E - Mail ID :
Family Income : 200000.00

Father's Office Address Mother's Office Address

DRAFT
Address Line 1 : 215 , NEO CORPORATE PLAZA , Address Line 1 :
RAMCHANDRA E Address Line 2 :
Address Line 2 : KANCHPADA , MALAD (E) City :
City : MUMBAI Country : India
Country : India State. : Maharashtra
State. : Maharashtra Pincode : 000000
Pincode : 400064 Telephone No. :

COPY
Declaration : I hereby declare that I have registered myself at the University website http://mum.digitaluniversity.ac.
I certify and declare that the information provided by me in the Pre-admission Online Registration Form and the Online Admission
Form is same and correct. In case of any discrepancy and/or submission of incomplete form I am aware that my form will be rejected
and that I shall loose my claim on the admission and that I shall not hold the college authorities responsible for the same.
I am aware of the University of Mumbai ordinance 6086 relating to the minimum 75% requirement of attendance of learners.
I abide by the rules and regulation of the college. Also , I understand the management of the college reserves the right of admission .

Name & Signature of the Student

No Application form will be processed or considered without Online Payment of application processing fees

Page 2 of 2 User: OMMISHRA123 Application No.