Session 2021-2022

RAMNIVAS RUIA JUNIOR Application for

COLLEGE Admission to
SYJC ARTS
Session 2021-2022
L.N. ROAD,MATUNGA, MUMBAI-400019 Application No. :
2625780

A) Personal Details

KAMBLE RUTUJA SANTOSH ROHITA

Name of the Student

Surname First Name Father's Name Mother's Name

Student Name (MARATHI) ऋततजज ससततष कजसबळळ

Date of Birth 16/06/2004 Place Of Birth MUMBAI

State of Birth District of Birth Please Select

Gender FEMALE Blood Group O+
Nationality INDIAN Religion HINDU
Caste Category NT-B Caste HINDU GAVLI

Sub Caste Aadhaar card Number 985432502944

Mother Tongue MARATHI Handicap NONE

UDISE No (Std X) 27230209245 Student has Smart phone YES

Student has a Laptop NO

Student has internet YES Bank Name CANARA BANK

connectivity
Account No. 0112127001723 IFSC CNRB0000112
Father's Name :

Father's Occupation :

Father's Organisation Address :

B) Address Details

Address Room No. 259 2/4, Municipal Chawl, Mukund Nagar, Dharvi, Mum - 400017

Municipal ward

City/Town/Village MUMBAI District MUMBAI

State maharastra Pincode 400017

Permanent Residential Address

Address Room No. 259 2/4, Municipal Chawl, Mukund Nagar, Dharvi, Mum - 400017

Municipal ward

City/Town/Village MUMBAI District MUMBAI

State maharastra Pincode 400017

 C) Contact Details

Mobile : 8424868465 Email Id : Rutujakamble905@gmail.com

Parent Mobile : 8424868465

Sr.No. Subject Name Subject Type

Group Name :

1 ENGLISH COMPULSORY

2 ECONOMICS COMPULSORY

3 POLITICAL SCIENCE COMPULSORY

4 ENVIRONMENTAL EDUCATION COMPULSORY

5 HEALTH AND PHYSICAL EDUCATION COMPULSORY

6 SOCIOLOGY OPTIONAL

7 SANSKRIT OPTIONAL

8 PSYCHOLOGY OPTIONAL

Note

1 Due to pandemic situation I have noted, understood and accepted that the college may complete some course material and
examinations online.

2 I undertake to take due precautions for safety for all by maintaining social distance and not resorting to crowding in college
premises. I shall immediately report to the college if any symptoms associated with Corona virus are noticed by me.

3 I have read the rules regarding admission and shall fully abide by them. I also understand and accept that if any
discrepancy is found in the disclosures made by me in my admission form, the college will take appropriate action including
cancellation of my admission without any refund of fees.

Date : 28/06/2021 Signature of the Student

4 I have permitted my son/ daughter/ ward to join this college and I have read the details submitted by him in the admission
form. I reiterate that the contents are true and correct. I also assure that my son/daughter/ward shall observe the rules and regulations
of the college.

Date : 28/06/2021 Signature of the Guardian/Parent

REMARK OF THE ADMISSION COMMITTEE

May be admitted to Class ____________________________________________________ Section ________________

May be Rejected __________________________________________________________________________________
Last date of payment of fees _________________________________________________________________________
Admission may be cancelled if the fees are not paid by this date.

Principal Signature of Admission Committee