Session 2020-2021

SETH KESARIMAL PORWAL COLLEGE OF College Code

:SKPC
ARTS, SCIENCE AND COMMERCE

KAMPTEE

For College Course Applied to: BSC SEM-1 Registration No.

use only 720341

Admission Date :

01. Personal Information Section

LAST NAME FIRST NAME MIDDLE NAME

Name of the Student MESHRAM NAVJEET ARUN

Father's Name

Mother's Name : VANDANA

Marital Status : Saral No. :

Date of Birth : 01/07/2000 Gender : Male

Place of Birth : Blood Group :

Grandfather Name : Native Place :

Voter ID Card No. : Organ Donar : NO Medium : English

Bank Name : Account No. : Transaction Type : ONLINE

Religion : HINDU Citizenship of : U-DISE No. :

Aadhar Card No. : 330741425122 Driving Licence No. : Minority: NO

02. Address Details

Address for Correspondence: NEAR RAMABAI STATUE RAMANGAR

Pin Code : 441001

State : MAHARASHTRA District : NAGPUR Tehsil : City : KAMPTEE (M CL)

NEAR RAMABAI STATUE RAMANGAR
Permanent Address Pin Code : 441001

State : MAHARASHTRA District : NAGPUR Tehsil : City : KAMPTEE (M CL)

03. Contact Details

Student Phone : Parent Phone : 9595183013

Student Mobile No.: 8928727391 Student Email Id: 2menavjeet@gmail.com

04. Legal Reservation Information Section

Domicile State : Type of Category : Caste Category : SC

Sub Caste : mahar Phy. Handicapped :
Caste Certificate No. : Learning Disability No. :

05. Social Reservation (Special Category) Information Section

 SR NO. SOCIAL RESERVATION NAME

06. Education Details Section

Name of Name of School Date of Examination Passing Grade / Obt CGPA
Name of
Board / College Passing Seat No. Certificate No. Total Marks %
Examination
Marks

SSC MAHARASHTRA NUTAN 08/06/20 J108812 500 402 80.40 0.00

STATE BOARD OF SARASWATI 15
SECONDARY BOYES HIGH
EDUCATION SCHOOL
KAMPTEE

SENIOR NATIONAL 1100061830 500 300 60.00 0.00

SECONDA INSTITUTE OF 11
RY OPEN
SCHOOLING

07. Qualifying Exam Details Section

Qualifying Exam Name : HSC / 12 TH
College/School Board/ Admission Passing Marks Total Percentage Place Arts/Com Education
Attended University Year Year Obt Marks /Sci Gap

NATIONAL INSTITUTE OF 0 0 300 500 60.00 NO

OPEN SCHOOLING

Qualifying Exam Subject Details

Sr.No. Subject Name Total Marks Obtained Marks

1

08. Subject Details Section

Language Details

Language 1 Language 2

ENGLISH SUPPLEMENTARY ENGLISH

Sr.No. Subject Name Subject Type

Group Name :

1 BOTANY OPTIONAL

2 CHEMISTRY OPTIONAL

3 ZOOLOGY OPTIONAL

09. Attached Documents

Sr No. Name of Documents/Certificates

1 TRANSFER CERTIFICATE

2 HSSC MARKSHEET

3 SSC MARK SHEET

10. Guardian / Parent Information Section

Guardian's/ Parent's Name :

Occupation of the Guardian/Parent : Annual Income of the guardian/Parent :

Relationship of Guardian with applicant : -- Guardian/Parent Phone No. : 9595183013

11. Other Information Section
Mother Tongue : Marathi Employment Status : NO Do you wish to join NCC / NSS: NO

Would you like to apply for Hostel : NO

Hobbies, Proficiency and Other interests : NA

Games and sports participation :

Personal Identification Marks : --

12. Declaration by Student

I hereby declare that, I have read the rules related to admission and the information filled in by me
in this form is accurate and true to the best of my knowledge. I will be responsible for any discrepancy, arising out of the form
signed by me and I undertake that, in absence of any document the final admission will not be granted and / or admission will
stand cancel.

Place :

Date :
Signature of the Student:

13. Declaration by Guardian / Parent

I have permitted my son / daughter / ward to join your college.The information supplied by him / her is
correct to the best of my knowledge. I have acquainted myself with the rules and fees, dues to my son / daughter / ward and see
that he / she observes.

Place :

Date :
Signature of the Guardian/Parent:
14. For College / Institute Use Only
Designation Remarks / Particulars /Recommendations Signature and Date

Admission Clerk
Admission Committee
Accountant / Cashier

Registrar/Office Cash Received : Rs 75.00

Superintendent

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