RGI Registration Form for Admission

Application No: RGI/ON/2020-21/14293

Program Selection / Personal Details

Program Selection
G H RAISONI COLLEGE OF
Program UNDER GRADUATE Course BBA Institute COMMERCE, SCIENCE AND
TECHNOLOGY, NAGPUR
Specialization Specialization Specialization
BBA
Preference 1 Preference 2 Preference 3
G H RAISONI
COLLEGE OF
Institute Backend COMMERCE,
Office Use only 2 OTHERS
Value SCIENCE AND
TECHNOLOGY,
NAGPUR
Personal Details
Title MR First Name SHUBHAM Middle Name
Last Name HEDAU Email ID (Primary) SHUBHAMHEDAU367@GMAIL.COM Alternate Email ID HEDAUSHUBHAM93@GMAIL.COM
Alternative Mobile
Mobile Number +91-6265834646 +91-8989004916 Date of Birth 14/11/2002
Number
Gender MALE Blood Group B+ Religion HINDUISM
Nationality INDIAN Caste Category GENERAL Mother Tongue MARATHI
Student Aadhar
423233419216 Domicile State MADHYA PRADESH Differently Abled? NO
Card Number
Specify your
Disability % Reference Number 9407024009
Disability
Passport Details
Passport Number Place of Issue Date of Issue
Date of Expiry
Father's Details
PURUSHOTTAM Father's Mobile
Father's Name +91-9407024009 Father's Email ID PURUSHOTTAM.HEDAU@SBI.CO.IN
HEDAU Number
Father's GOVERNMENT Father's
CHIEF MANAGER, SBI
Occupation SECTOR Designation
Mother's Details
Mother's Name SHILPA HEDAU

Address Details
Address for Correspondence
Country INDIA State MADHYA PRADESH District BHOPAL
H352 AADHARSHILA WEST BLOCK
City / Taluka BHOPAL Address Line 1 Address Line 2 BHOPAL
AWADHPURI BHOPAL
Is Permanent
Address Same As
Pincode 462022 YES
Address For
Communication?
Permanent Address
Country INDIA State MADHYA PRADESH District BHOPAL
H352 AADHARSHILA WEST BLOCK
City / Taluka BHOPAL Address Line 1 Address Line 2 BHOPAL
AWADHPURI BHOPAL
Pincode 462022 Village / Landmark BHOPAL Village / Landmark

Academic Details
10th /Xth Details
10th Result Status DECLARED 10th School State MADHYA PRADESH 10th School City BHOPAL
10th Details

Name of School Board Year of Passing Marking Scheme Percentage / CGPA

CENTRAL BOARD OF SECONDARY EDUCATION
10th ST. XAVIER'S SR SEC CO-ED SCHOOL 2019 PERCENTAGE 67.4
(CBSE)

After 10th Qualification 12TH

Diploma Details
Diploma Result Status Diploma Institute State Diploma Institute City
Diploma Details

Institute Name University Year of Passing Marking Scheme Percentage / CGPA

Diploma

12th /XIIth Details

12th Result Status AWAITED 12th School State MADHYA PRADESH 12th School City BHOPAL
12th Details

Name of School Board Stream Year of Passing Marking Scheme Percentage / CGPA
ST. XAVIER'S SR SEC CO-ED CENTRAL BOARD OF SECONDARY
12th COMMERCE 2021
SCHOOL EDUCATION (CBSE)

PCM & Vocation Subjects Course Details

Maximum Marks Obtained Marks

Physics
Chemistry
Maths
Vocational Subject

Graduation Details
Graduation State Graduation University Graduation Institute
Graduation Details

Degree Branch / Specialization Year of Passing Result Status Marking Scheme Percentage / CGPA
UG

Post Graduation Details

Degree Branch / Specialization Year of Passing Result Status Marking Scheme Percentage / CGPA
PG

PG Qualifying Exam Details

Exam Name Branch Year of Passing Mark Obtained Out of Marks Percentage / CGPA
Qualifying Exam

JEE and MH-CET for Engineering

Physics Chemistry Maths PCM Out of Marks Passing Year

JEE
MH-CET

Upload and Declaration

Upload Documents

Upload Your Recent Upload Your 10th

Upload Your Signature : YES
Passport Size Photo : Certificate :

Upload Your 12th Upload Your Diploma Upload Your Graduation

NO NO NO
Certificate : Certificate : Certificate :

Upload Your JEE and

Upload your Graduation Upload Your PG
NO NO MH-CET Exam Score NO
Marksheet : Certificate :
Card :

Upload Your Student

Aadhaar Card/ Identity YES
Card :

Declaration
1. I CERTIFY THAT THE INFORMATION SUBMITTED BY ME IN SUPPORT OF THIS APPLICATION, IS TRUE TO THE BEST OF KNOWLEDGE AND BELIEF. I UNDERSTAND THAT IN THE EVENT OF ANY
INFORMATION BEING FOUND FALSE OR INCORRECT, MY ADMISSION IS LIABLE TO BE REJECTED / CANCELLED AT ANY STAGE OF THE PROGRAM. I UNDERTAKE TO ABIDE BY THE DISCIPLINARY
RULES AND REGULATIONS OF THE INSTITUTE.
2. WE ARE AWARE THAT TUITION FEES ARE PRESCRIBED BY FEES REGULATORY COMMITTEE AND ARE SUBJECT TO REVISION. THUS, WE UNDERTAKE TO PAY THE DIFFERENCE, IF ANY, AS AND
WHEN PRESCRIBED BY THE COMMITTEE.
3. WE DECLARE THAT MY WARD SHALL ATTAIN MINIMUM ATTENDANCE AS PER UNIVERSITY NORMS SO AS TO BE ELIGIBLE FOR APPEARING IN THE MID-SEMESTER EXAMINATION & SEMESTER-END
EXAMINATION.
4. WE DECLARE THAT ANY INFORMATION FOUND INCORRECT MAY LEAD TO THE CANCELLATION OF MY WARDS ADMISSION.
5. I AND MY WARD CERTIFY THAT THE PREVIOUS BOARDS WHICH HAVE BEEN STUDIED IS CERTIFIED ARE VALID BOARDS. IF IN FUTURE THE PREVIOUSLY CLEARED BOARDS ARE REFLECTED AS
INVALID THEN WE ARE AWARE THAT THE ADMISSION STANDS CANCEL WITHOUT ANY EXPLANATIONS FROM THE CONCERNED COLLEGE AUTHORITY.
6.COLLEGE HAS AN AUTHORITY TO CANCEL ADMISSION IF THE COLLEGE FOUND ANY DEFAULT, ADMISSION WILL APPROVE ONLY AFTER VERIFICATION OF DOCUMENTS.

PURUSHOTTAM
Applicant Name SHUBHAM HEDAU Parent Name Date 01/07/2021
HEDAU
checkbox I AGREE