8/24/2021

For Office Use

Batch: Scrutiny Payment: Online/DD PI

Only Serial:

VPM`s Dr.V.N.Bedekar Institute of Management Studies (743)

Application No :

University of Mumbai 2185892

M.G.Road, Fort, Mumbai-400032, Maharashtra(India)

Academic Year: 2021-2022

Regular
APPLICATION FORM

Course Applied for : M.M.S.(with Credits) - Regular - Rev16 - S.Y. M.M.S. Sem III 
(-) PRN:2016016401218093
Application Date : 24/08/2021 Payment Category : 35

1.Personal Information

Candidate's Name(Regional) :
Candidate's Name as printed on Mark SHINDE ANIRUDHA VINAYAK
sheet : [*This name will appear on all University records/documents]

Father's/Husband's Name : VINAYAK SHINDE Mother's Name : SANGITA

Marital Status : UnMarried Mother Tongue :

Place Of Birth : CHIPLUN Gender : Male Date of Birth (DD/MM/YYYY) : 08/10/1998
Blood Group : Religion : Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Ratnagiri Tehsil : Chiplun City/Town/Village :
Available
Address (House
HOUSE NO 112 SARASWATI SWAPNA BEHIND VAIBHAV HOTEL RAOTALE Pin Code : 415605
no,street/area/suburb etc.) :
Contact details
Mobile Number 919822860412 Email ID: ANIRUDHA.SHINDE98@GMAIL.COM
2.Legal Reservation Information
Category Type : Open Category : GEN
Is Specially Abled? No
3.Social Information(Additional Inforamtion)

Paper Selected for:

Sem III
UMMSIII.1 - International Business UMMSIII.2 - Strategic Management
MMSOP101.2 - Business Process Engineering And Benchmarking MMSOP101 - Supply Chain Management
MMSOP102 - Operations Analytics MMSOP103 - Service Operations Management
MMSOP104 - Manufacturing Resource Planning & Control MMSOP105 - Materials Management
Sem IV

UMMSIV.6 - Project Management UMMSIV.7 - Project Functional Specialization

UMMSIV.8 - Project Social Relevance UMMSIV.9 - Project General Management
UMMSIV.6.10 - Operations Applications and Cases

Medium of Instruction : English

4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 300000
5.Educational Details
Month and Exam
Name of Name of Board/University and State of Name of Certificate Mark
Year of Seat Out of CGPA %
Examination University School/College No. Obtained
Passing No.
MAHARASHTRA STATE BOARD OF
Std 10th SECONDARY AND HIGHER March 2014 -- -- 428.00 500.00 --
-
-- 85.60
SECONDARY EDUCATION,
MAHARASHTRA STATE BOARD OF
Std 12th 12Th February
SECONDARY AND HIGHER -- -- 308.00 650.00 --
-
-- 47.38
(Science) 2016
SECONDARY EDUCATION,

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Month and Exam

Name of Name of Board/University and State of Name of Certificate Mark
Year of Seat Out of CGPA %
Examination University School/College No. Obtained
Passing No.
Degree : B.Sc.(With
Credits)-Regular- Passed -- -- - - --
-
-- -
Rev16
Your Last Qualifying Exam:
7.Other Information
Would you like to apply for Hostel accommodation required NA
DECLARATION
I hereby declare that all the information furnished by me in this application form
is true, complete and correct to the best of my knowledge and belief. I do
understand
that I need to obtain and produce all the required documents.
I
admit to having understood what constitutes ragging and sexual harassment. I
have
read the guidelines related to the same. I hereby affirm that if found guilty of
ragging or sexual harassment I am liable for punishment according to
the university
regulations.

Place : Date  :
( Signature of the Candidate )
Document printed on Tue Aug 24 2021 23:47:49 GMT+0530 (India Standard Time)

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