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Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon

http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117574
2014015400119235 Eligible

Instruction Medium: Nationality: India


Student's Name: SURYAVANSHI ANIKET TULSHIDAS Mother's Name: REKHA Gender: Male
Name in Vernacular Language:  Ǘ™[ȲžȢ\Ǔ“€ȯǕœžȢ‘ȡ 
Address: PLOT NO 42 MAHALAXMI NAGAR BEHIND HERO HONDA SHOWROOM OLD JALGAON ROAD BHUSAWAL
City: BHUSAWAL, Taluka: Bhusawal, District: Jalgaon, State: Maharashtra, PIN: 425201
Telephone no.: Mobile no: 918237640268 Email :
DOB: Dec 01, 1996 Category: Reserved (NT-1 (NT-B)) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117575
2015015400389505 Eligible

Instruction Medium: Nationality: India


Student's Name: SHAIKH ASIF ASHFAQUE Mother's Name: RUKHSANA Gender: Male
Name in Vernacular Language: žȯ]ͧ •\ž•€
Address: SABERA COTTAGE NEW IDGAH COLONY BEHIND APNI BAKERY KHADKA SQUARE
City: BHUSAWAL, Taluka: Bhusawal, District: Jalgaon, State: Maharashtra, PIN: 425201
Telephone no.: Mobile no: 9028856504 Email : SHAIKHASIF120@GMAIL.COM
DOB: Nov 06, 1997 Category: Open Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117576
2016015400054213 Eligible

Instruction Medium: Nationality: India


Student's Name: CHAUDHARI BHAVIN MANOHAR Mother's Name: VANDANA Gender: Male
Name in Vernacular Language: CHAUDHARI BHAVIN MANOHAR
Address: At Post Akulkheda Tal Chopda At Post Akulkheda Tal Chopda
City: Akulkheda, Taluka: Chopada, District: Jalgaon, State: Maharashtra, PIN: 425107
Telephone no.: Mobile no: 919923568527 Email : bhavinchaudhary147@gmail.com
DOB: Jun 02, 1998 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117577
2016015400158436 Eligible

Instruction Medium: Nationality: India


Student's Name: PATIL ADITYA PRABHAKAR Mother's Name: SHOBHA Gender: Male
Name in Vernacular Language: ”ȡŠȣ›]Ǒ‘×™Ĥ—ȡ€š
Address: MADHUBAN PLOT NO 44 SANE GURUJI NAGAR HIRAPUR ROAD
City: CHALISGAON, Taluka: Chalisgaon, District: Jalgaon, State: Maharashtra, PIN: 424101
Telephone no.: Mobile no: 9049377309 Email : patiladitya40404@gmail.com
DOB: Nov 20, 1998 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117578
2016015400204003 Eligible

Instruction Medium: Nationality: India


Student's Name: PATIL DIVYANI SHASHIKANT Mother's Name: SHAILA Gender: Female
Name in Vernacular Language: ”ȡŠȣ›Ǒ‘å™ȡȲ“Ȣžͧž€ȡȲ
Address: AT POST VARANGAON AT POST VARANGAON
City: VARANGAON, Taluka: Bhusawal, District: Jalgaon, State: Maharashtra, PIN: 425305
Telephone no.: Mobile no: 9607733317 Email : divyanipatil596@gmail.com
DOB: Sep 29, 1998 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117579
2016015400283002 Eligible

Instruction Medium: Nationality: India


Student's Name: YEOLE RUTUJA NARAYAN Mother's Name: YASHODA Gender: Female
Name in Vernacular Language: ™ȯ›ȯbǕ‡ȡ“ȡšȡ™Ž
Address: AP UMBARKHED
City: UMBARKHED, Taluka: Chalisgaon, District: Jalgaon, State: Maharashtra, PIN: 424116
Telephone no.: Mobile no: 9021324934 Email : rutuja91576@gmail.com
DOB: Oct 15, 1998 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117580
2016015400284311 Eligible

Instruction Medium: Nationality: India


Student's Name: SONAWANE SHUBHAM GAJANAN Mother's Name: PRAMILABAI Gender: Male
Name in Vernacular Language:  Ȫ“ŽȯžǕ—˜‚‡ȡ““
Address: AT POST MALDABHADI TAL JAMNER
City: MALDABHADI, Taluka: Jamner, District: Jalgaon, State: Maharashtra, PIN: 424206
Telephone no.: Mobile no: 918160318003 Email : sonawaneshubham63@gmail.com
DOB: Jul 28, 1998 Category: Reserved (ST) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117581
2016015400327885 Eligible

Instruction Medium: Nationality: India


Student's Name: KALE AISHWARYA VIJAY Mother's Name: PRAMILABAI Gender: Female
Name in Vernacular Language: €ȡœȯg杙ȡ[ͪ‡™
Address: SHIVAJI NAGAR NEAR BUS STAND
City: PACHORA, Taluka: Pachora, District: Jalgaon, State: Maharashtra, PIN: 424201
Telephone no.: Mobile no: 919226170153 Email : AKALE123@GMAIL.COM
DOB: Jul 04, 1999 Category: Open Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117582
2016015400330342 Eligible

Instruction Medium: Nationality: India


Student's Name: JAISAWAL ROSHAN VIJAY Mother's Name: SHARADA Gender: Male
Name in Vernacular Language: ‡Ȱ ȡ›šȪž“ͪ‡™
Address: AT POST SONWAD TAL DHARANGAON
City: DHARANGAON, Taluka: Dharangaon, District: Jalgaon, State: Maharashtra, PIN: 425104
Telephone no.: Mobile no: 7083597475 Email : roshanjaiswal4122@gmail.com
DOB: Dec 14, 1998 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117569
2016015400333344 Eligible

Instruction Medium: Nationality: India


Student's Name: PATIL PRASHANT CHATUR Mother's Name: SARLA Gender: Male
Name in Vernacular Language: ”ȡǑŠ›ĤžȡȲ…Ǖš
Address: SWAMI NARAYAN NAGAR PAROLA JALGAON
City: PAROLA, Taluka: Parola, District: Jalgaon, State: Maharashtra, PIN: 425111
Telephone no.: Mobile no: 919096245297 Email : PPRASHANT668@GMAIL.COM
DOB: May 07, 1998 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):
2. Sem-III(Regular-under CBCS [June-2020] Pattern- Previous Details: Sem-III(Regular-under CBCS [June-2020] Pattern), Dec-2021, Seat No.: 384984, Result:
No Branch) ATKT
Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
2 251306 CA LAB-IX LAB on Design and Analysis of Algorithms PR-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117584
2016015400407182 Eligible

Instruction Medium: Nationality: India


Student's Name: GHULE RITESH GAJANAN Mother's Name: ASHA Gender: Male
Name in Vernacular Language: ƒǕ›ȯǐšȯž‚‡ȡ““
Address: AT POST NERI TAL JAMENR
City: JAMENR, Taluka: Jamner, District: Jalgaon, State: Maharashtra, PIN: 425114
Telephone no.: Mobile no: 7028371513 Email :
DOB: Sep 20, 1998 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117585
2017015400032652 Eligible

Instruction Medium: Nationality: India


Student's Name: MAHAJAN CHETANA SANJAY Mother's Name: SUNITA Gender: Female
Name in Vernacular Language: ˜¡ȡ‡“…ȯ“ȡ Ȳ‡™
Address: RAVER
City: RAVER, Taluka: Raver, District: Jalgaon, State: Maharashtra, PIN: 425508
Telephone no.: Mobile no: 9359041019 Email : CHETANASMAHAJAN@GMAIL.COM
DOB: Jan 21, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117586
2017015400033802 Eligible

Instruction Medium: Nationality: India


Student's Name: SHIRSATH BUDDHABHUSHAN NAVAL Mother's Name: SHOBHA Gender: Male
Name in Vernacular Language: ͧžš ȡ‹–Ǖɮ’—ǗŸŽ“›
Address: SUNDERGADHI CHOPDA TAL CHOPDA DIST JALGAON
City: CHOPDA, Taluka: Chopada, District: Jalgaon, State: Maharashtra, PIN: 425107
Telephone no.: Mobile no: 918380870716 Email : mebhsh98@gmail.com
DOB: Aug 15, 1998 Category: Reserved (SC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117587
2017015400039443 Eligible

Instruction Medium: Nationality: India


Student's Name: ZOPE ASMITA SUBHASH Mother's Name: ALKA Gender: Female
Name in Vernacular Language: ˆȪ”ȯ\ǔ蘏ȡ Ǖ—ȡŸ
Address: DOWN LANE NASHIRABAD
City: NASHIRABAD, Taluka: Jalgaon, District: Jalgaon, State: Maharashtra, PIN: 425309
Telephone no.: Mobile no: 918698120637 Email : ASMITAZOPE0990@GMAIL.COM
DOB: Feb 22, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117570
2017015400040237 Eligible

Instruction Medium: Nationality: India


Student's Name: SURALKAR NAMRATA BHAGWAN Mother's Name: MADHURI Gender: Female
Name in Vernacular Language:  Ǖšœ€š“Ĩȡ—‚ȡ“
Address: QUARTER NO 30 BY A TYPE 3 O F VARANGAON
City: VARANGAON, Taluka: Bhusawal, District: Jalgaon, State: Maharashtra, PIN: 425308
Telephone no.: Mobile no: 7066830032 Email : bhagwansuralkar199@gmail.com
DOB: Sep 29, 1999 Category: Reserved (SC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):
2. Sem-III(Regular-under CBCS [June-2020] Pattern- Previous Details: Sem-III(Regular-under CBCS [June-2020] Pattern), Dec-2021, Seat No.: 385007, Result:
No Branch) ATKT
Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
2 251342 CA-304(B) AI in Practice with Python TH-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117589
2017015400060652 Eligible

Instruction Medium: Nationality: India


Student's Name: JAGTAP DIMPAL GAJANAN Mother's Name: ARUNA Gender: Female
Name in Vernacular Language: ‡‚ȡ”ͫŒà”›‚‡ȡ““
Address: RAIPUR KUSUMBA KHURD
City: JALGAON, Taluka: Jalgaon, District: Jalgaon, State: Maharashtra, PIN: 425001
Telephone no.: Mobile no: 8390298559 Email : dimpaljagtap761@gmail.com
DOB: Jan 18, 2000 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117590
2017015400060822 Eligible

Instruction Medium: Nationality: India


Student's Name: CHOUDHARI NEHA ARUN Mother's Name: VAISHALI Gender: Female
Name in Vernacular Language: “ȯ¡ȡ\ǽŽ…ȫ’šȣ
Address: DR ANNASAHEB GD BENDALE HOSTEL
City: JALGAON, Taluka: Jalgaon, District: Jalgaon, State: Maharashtra, PIN: 425001
Telephone no.: Mobile no: 917378326323 Email : nehachoudhari29@gmail.com
DOB: Dec 29, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117591
2017015400060853 Eligible

Instruction Medium: Nationality: India


Student's Name: BAVISKAR SHITAL NARAYAN Mother's Name: SANGITA Gender: Female
Name in Vernacular Language: –ȡͪè€šžȢ›“ȡšȡ™Ž
Address: SAMNTA NAGAR ADAKMOL GALLI
City: JALGAON, Taluka: Jalgaon, District: Jalgaon, State: Maharashtra, PIN: 425001
Telephone no.: Mobile no: 917841981642 Email : SHITALBAVISKAR1998@GMAIL.COM
DOB: Oct 31, 1998 Category: Reserved (SC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117592
2017015400071545 Eligible

Instruction Medium: Nationality: India


Student's Name: TIWARI DIVYANI PRAKASH Mother's Name: NISHA Gender: Female
Name in Vernacular Language: ǓȡšȣǑ‘å™ȡȲ“ȢĤ€ȡž
Address: DHANSHREE SNEH NAGAR ZTC BHUSAWAL
City: BHUSAWAL, Taluka: Bhusawal, District: Jalgaon, State: Maharashtra, PIN: 425201
Telephone no.: Mobile no: 7767903967 Email : AJAYT93@GMAIL.COM
DOB: Dec 17, 1999 Category: Open Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117593
2017015400091685 Eligible

Instruction Medium: Nationality: India


Student's Name: MORE PRANIKET RAJENDRA Mother's Name: JYOTI Gender: Male
Name in Vernacular Language: ˜ȪšȯĤȡͨŽ€ȯšȡ‡Ʌġ
Address: KURKHALI
City: SHIRPUR, Taluka: Shirpur, District: Dhule, State: Maharashtra, PIN: 425405
Telephone no.: Mobile no: 8999768547 Email :
DOB: Mar 17, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117594
2017015400125444 Eligible

Instruction Medium: Nationality: India


Student's Name: MARATHE DHANSHREE NAMDEV Mother's Name: SULOCHANA Gender: Female
Name in Vernacular Language: ˜šȡ‹ȯ’“ĮȢ“ȡ˜‘ȯ
Address: DESHMUKHWADI PACHORA
City: PACHORA, Taluka: Pachora, District: Jalgaon, State: Maharashtra, PIN: 424201
Telephone no.: Mobile no: 8805125201 Email : dhanshreemarathe2000@gmail.com
DOB: Apr 25, 2000 Category: Open Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117456
2017015400127404 Eligible

Instruction Medium: Nationality: India


Student's Name: DEORE BHAGYASHRI MANOHAR Mother's Name: VAISHALI Gender: Female
Name in Vernacular Language: ‘ȯšȯ—ȡʙĮȢ˜“Ȫ¡š
Address: AT LASURE POST VARKHEDI TAL PACHORA
City: PACHORA, Taluka: Pachora, District: Jalgaon, State: Maharashtra, PIN: 424202
Telephone no.: Mobile no: 7420074199 Email : bhagyashrideore66@gmail.com
DOB: Jan 16, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):
2. Sem-III(Regular-under CBCS [June-2020] Pattern- Previous Details: Sem-III(Regular-under CBCS [June-2020] Pattern), Dec-2021, Seat No.: 385006, Result:
No Branch) ATKT
Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
2 251302 CA-302 Design and Analysis of Algorithms TH-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):
3. Sem-II(Regular-under CBCS [June-2020] Pattern- Previous Details: Sem-II(Regular-under CBCS [June-2020] Pattern), May-2021, Seat No.: 378293, Result:
No Branch) Fail
Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
3 251241 CA-204 A) Machine Learning TH-CA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117596
2017015400127524 Eligible

Instruction Medium: Nationality: India


Student's Name: DEORE GAURAV KAILAS Mother's Name: SUNITA Gender: Male
Name in Vernacular Language: ‘ȯšȯ‚ȫš€Ȱ›ȡ 
Address: SHANKAR APPA COLONY GIRNA PUMPING ROAD PACHORA
City: PACHORA, Taluka: Pachora, District: Jalgaon, State: Maharashtra, PIN: 424201
Telephone no.: Mobile no: 919890588049 Email : GAURAVDEORE960@GMAIL.COM
DOB: Aug 09, 1998 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117597
2017015400178306 Eligible

Instruction Medium: Nationality: India


Student's Name: SARODE PRIYANKA DILIP Mother's Name: SADHANA Gender: Female
Name in Vernacular Language:  šȪ‘ȯͪĤ™ȡȲ€ȡǑ‘›ȣ”
Address: at po pimpalgaon bk
City: pimpalgaon bk, Taluka: Bhusawal, District: Jalgaon, State: Maharashtra, PIN: 425305
Telephone no.: Mobile no: 8788649054 Email : priyankasarode2604@gmail.com
DOB: Apr 26, 2000 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117598
2017015400178496 Eligible

Instruction Medium: Nationality: India


Student's Name: PATIL SNEHAL SUNIL Mother's Name: MADHURI Gender: Female
Name in Vernacular Language: ”ȡŠȣ›è“ȯ¡› Ǖ“Ȣ›
Address: AtAchegaon Po Achegaon
City: Achegaon, Taluka: Bhusawal, District: Jalgaon, State: Maharashtra, PIN: 425305
Telephone no.: Mobile no: 918421842297 Email : jainsanat63@gmail.com
DOB: Sep 15, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117599
2017015400178771 Eligible

Instruction Medium: Nationality: India


Student's Name: KOLTE PRANALI ANIL Mother's Name: VAISHALI Gender: Female
Name in Vernacular Language: €Ȫ›ȯĤŽȡ›ȣ\Ǔ“›
Address: AT POST BODWAD ROAD MUKTAINAGAR TAL MUKTAINAGAR DIST JALGOAN
City: MUKTAINAGAR, Taluka: Muktainagar, District: Jalgaon, State: Maharashtra, PIN: 425306
Telephone no.: Mobile no: 917770079211 Email : pranalikolte99@gmail.com
DOB: Sep 10, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117600
2017015400179051 Eligible

Instruction Medium: Nationality: India


Student's Name: PATIL RUTUJA RAJENDRA Mother's Name: KALPANA Gender: Female
Name in Vernacular Language: ”ȡŠȣ›bǕ‡ȡšȡ‡Ʌġ
Address: AT POST PIMPALGAON KHURD TAL BHUSAWAL DIST JALGAON
City: BHUSAWAL, Taluka: Bhusawal, District: Jalgaon, State: Maharashtra, PIN: 425305
Telephone no.: Mobile no: 917038387056 Email : rutuja81099@gmail.com
DOB: Oct 08, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117601
2017015400179406 Eligible

Instruction Medium: Nationality: India


Student's Name: ZAMBARE ANKITA NINA Mother's Name: JYOTI Gender: Female
Name in Vernacular Language: ˆȡȲ–šȯ\Ȳͩ€ȡ“Ȣ“ȡ
Address: tahashil road zambare vada muktainagar tahashil road zambare vada muktainagar
City: MUKTAINAGAR, Taluka: Muktainagar, District: Jalgaon, State: Maharashtra, PIN: 425306
Telephone no.: Mobile no: 917066554108 Email : ankitazambare5@gmail.com
DOB: Oct 05, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117602
2017015400179534 Eligible

Instruction Medium: Nationality: India


Student's Name: PATIL MINAL NARENDRA Mother's Name: PUSHPA Gender: Female
Name in Vernacular Language: ”ȡŠȣ›˜Ȣ“›“šɅġ
Address: HARI VITTHAL NAGAR TALVEL TAL BHUSAWAL DIST JALGAON
City: BHUSAWAL, Taluka: Bhusawal, District: Jalgaon, State: Maharashtra, PIN: 425305
Telephone no.: Mobile no: 919324238374 Email : minalpatil572000@gmail.com
DOB: Jul 05, 2000 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117603
2017015400179693 Eligible

Instruction Medium: Nationality: India


Student's Name: INGLE NAMRATA YASHWANT Mother's Name: USHA Gender: Female
Name in Vernacular Language: ^Ȳ‚œȯ“Ĩȡ™žȲ
Address: At Narwel Post Narwel
City: Narwel, Taluka: Malkapur, District: Buldhana, State: Maharashtra, PIN: 443112
Telephone no.: Mobile no: 919767389540 Email : prachiingle2199@gmail.com
DOB: Nov 20, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117604
2017015400179743 Eligible

Instruction Medium: Nationality: India


Student's Name: JAVARE JAYA VASANT Mother's Name: ALKA Gender: Female
Name in Vernacular Language: ‡šȯ‡™ȡ Ȳ
Address: BAKADA CHAUK TALVEL TAL BHUSAWAL DIST JALGAON
City: BHUSAWAL, Taluka: Bhusawal, District: Jalgaon, State: Maharashtra, PIN: 425305
Telephone no.: Mobile no: 919767925906 Email : jaya.javare@gmail.com
DOB: Feb 10, 1999 Category: Reserved (NT-2 (NT-C)) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117605
2017015400179894 Eligible

Instruction Medium: Nationality: India


Student's Name: BHANGALE VISHNU SUNIL Mother's Name: SARLA Gender: Male
Name in Vernacular Language: —Ȳ‚ȡœȯͪçŽǗ ǕǓ“›
Address: at malegaon post wadji tal motala dist bhuldhana
City: motala, Taluka: Motala, District: Buldhana, State: Maharashtra, PIN: 443101
Telephone no.: Mobile no: 918308504460 Email : vishnubhangale2015@gmail.com
DOB: Jul 29, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117606
2017015400179913 Eligible

Instruction Medium: Nationality: India


Student's Name: VITE AMOL ASHOK Mother's Name: SAVITA Gender: Male
Name in Vernacular Language: ͪŠȯ\˜Ȫ›\žȪ€
Address: At Rigaon Post Pimprala
City: Muktainagar, Taluka: Muktainagar, District: Jalgaon, State: Maharashtra, PIN: 425306
Telephone no.: Mobile no: 918308092028 Email : amolvite3@gmail.com
DOB: Jun 20, 1999 Category: Reserved (NT-1 (NT-B)) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117607
2017015400182544 Eligible

Instruction Medium: Nationality: India


Student's Name: PATIL VAISHALI SUNIL Mother's Name: ANNAPURNA Gender: Female
Name in Vernacular Language: PATIL VAISHALI SUNIL
Address: SHIJAJI NAGER KUDEL SHAHADA
City: SHAHADA, Taluka: Shahada, District: Nandurbar, State: Maharashtra, PIN: 425409
Telephone no.: Mobile no: 7378690110 Email :
DOB: Sep 12, 1998 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117608
2017015400183203 Eligible

Instruction Medium: Nationality: India


Student's Name: KHAKRE PALLVI MAHESH Mother's Name: SUREKHA Gender: Female
Name in Vernacular Language: ȡ€šȯ”㛝Ȣ˜¡ȯž
Address: A P SHENDURNI TA JAMNER
City: SHENDURNI, Taluka: Jamner, District: Jalgaon, State: Maharashtra, PIN: 424204
Telephone no.: Mobile no: 917756991090 Email : pankajbaviskar123@gmail.com
DOB: Mar 10, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117609
2017015400198334 Eligible

Instruction Medium: Nationality: India


Student's Name: KUMAVAT SHWETA RAVINDRA Mother's Name: SHOBHA Gender: Female
Name in Vernacular Language: €Ǖ˜ȡæȯȡšͪȲġ
Address: AT POST PAHUR TAL JAMNER DIST JALGAON
City: JAMNER, Taluka: Jamner, District: Jalgaon, State: Maharashtra, PIN: 424206
Telephone no.: Mobile no: 7387256179 Email : shvetakumavat137.055@gmail.com
DOB: Feb 06, 2000 Category: Reserved (NT-1 (NT-B)) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117610
2017015400220115 Eligible

Instruction Medium: Nationality: India


Student's Name: RATHOD SANDESH DEVIDAS Mother's Name: SANGITABAI Gender: Male
Name in Vernacular Language: šȡ‹ȪŒ Û‘ȯž‘ȯȢ‘ȡ 
Address: B128 GOVIND NAGAR
City: PACHORA, Taluka: Pachora, District: Jalgaon, State: Maharashtra, PIN: 424201
Telephone no.: Mobile no: 7020869148 Email :
DOB: Dec 26, 1997 Category: Reserved (VJ/DT(A)) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117572
2017015400228142 Eligible

Instruction Medium: Nationality: India


Student's Name: RATHOD ABHISHEK VISHWANATH Mother's Name: PUSHPA Gender: Male
Name in Vernacular Language: šȡ‹ȪŒ\ͧ—Ÿȯ€ͪæ“ȡ
Address: AT POST VALTHAN TANDA TAL CHALISGAON
City: VALTHAN, Taluka: Chalisgaon, District: Jalgaon, State: Maharashtra, PIN: 424101
Telephone no.: Mobile no: 919270278827 Email : abhivrathod@gmail.com
DOB: Feb 15, 1999 Category: Open Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):
2. Sem-III(Regular-under CBCS [June-2020] Pattern- Previous Details: Sem-III(Regular-under CBCS [June-2020] Pattern), Dec-2021, Seat No.: 384989, Result:
No Branch) ATKT
Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
2 251306 CA LAB-IX LAB on Design and Analysis of Algorithms PR-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117573
2017015400254093 Eligible

Instruction Medium: Nationality: India


Student's Name: PATIL KOMAL ASHOK Mother's Name: JYOTI Gender: Female
Name in Vernacular Language: ”ȡŠȣ›€Ȫ˜›\žȪ€
Address: at Salshingi Post Salshingi
City: Salshingi, Taluka: Bodwad, District: Jalgaon, State: Maharashtra, PIN: 425310
Telephone no.: Mobile no: 9309719870 Email : chaitanya_mscit@yahoo.com
DOB: Nov 07, 1998 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):
2. Sem-III(Regular-under CBCS [June-2020] Pattern- Previous Details: Sem-III(Regular-under CBCS [June-2020] Pattern), Dec-2021, Seat No.: 384982, Result:
No Branch) ATKT
Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
2 251301 CA-301 Compiler Construction TH-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117613
2017015400256262 Eligible

Instruction Medium: Nationality: India


Student's Name: KHAN MUSARRAT BI RASHID Mother's Name: NADAN BI Gender: Female
Name in Vernacular Language: ȡ“˜Ǘ š[–ȢšžȢ‘
Address: AT POST DHAMANGAON BADHE TAL MOTALA DIST BULDHANA
City: DHAMANGAON BADHE, Taluka: Motala, District: Buldhana, State: Maharashtra, PIN: 443104
Telephone no.: Mobile no: 7558741799 Email : nilesh.khadase83@gmail.com
DOB: Mar 30, 1999 Category: Open Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117614
2017015400274886 Eligible

Instruction Medium: Nationality: India


Student's Name: PANPATIL HARSHDA SUNIL Mother's Name: KAVITA Gender: Female
Name in Vernacular Language: ”ȡ“”ȡŠȣ›¡Ÿ[‘ȡ Ǖ“Ȣ›
Address: 11 VIVEKANAND NAGAR SOUTH OF RAMANAND JALGAON
City: JALGAON, Taluka: Jalgaon, District: Jalgaon, State: Maharashtra, PIN: 425001
Telephone no.: Mobile no: 919404254418 Email : HARSHDAPANPATIL99@GMAIL.COM
DOB: Oct 05, 1999 Category: Reserved (SC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117615
2017015400277084 Eligible

Instruction Medium: Nationality: India


Student's Name: PARDESHI TEJASSINGH VIJAYSINGH Mother's Name: PUSHPA Gender: Male
Name in Vernacular Language: ”š‘ȯžȢȯ‡ ͧ Ȳ¡ͪ‡™ͧ Ȳ¡
Address: 255 SHIVAJI NAGAR JALGAON
City: JALGAON, Taluka: Jalgaon, District: Jalgaon, State: Maharashtra, PIN: 425001
Telephone no.: Mobile no: 7888192201 Email : tejaspardeshi212@gmail.com
DOB: Jan 02, 2000 Category: Open Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117616
2017015400278571 Eligible

Instruction Medium: Nationality: India


Student's Name: NAIK MANDAR RAGHUNATH Mother's Name: RAJSHREE Gender: Male
Name in Vernacular Language: ˜Ȳ‘ȡš
Address: upper lane main road naik wada nashirabad
City: NASHIRABAD, Taluka: Jalgaon, District: Jalgaon, State: Maharashtra, PIN: 425309
Telephone no.: Mobile no: 918149124628 Email : naikmandar6@gmail.com
DOB: Mar 29, 1999 Category: Open Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117617
2017015400290251 Eligible

Instruction Medium: Nationality: India


Student's Name: ARSALAN AHEMAD AFZAAL AHEMAD SHAIKH Mother's Name: MAHERUNNISA Gender: Male
Name in Vernacular Language: \ [›ȡ“\¡˜‘\•ˆ›\¡˜‘žȯ
Address: R NO 3 P NO 14 AQSA NAGAR MEHRUN
City: JALGAON, Taluka: Jalgaon, District: Jalgaon, State: Maharashtra, PIN: 425001
Telephone no.: Mobile no: 919028299380 Email : arsalanshaikh.afzaal@gmail.com
DOB: Nov 10, 1997 Category: Open Physically Handicap: Orthopedic Disorder
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117618
2017015400295101 Eligible

Instruction Medium: Nationality: India


Student's Name: DEO SAYALI MILIND Mother's Name: KSHAMA Gender: Female
Name in Vernacular Language: ‘ȯ ȡ™›ȣͧ˜ͧ›Ȳ‘
Address: PIMPALGAON HARESHWAR PACHORA
City: PIMPALGAON, Taluka: Pachora, District: Jalgaon, State: Maharashtra, PIN: 424201
Telephone no.: Mobile no: 9404810856 Email :
DOB: May 06, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117619
2017015400333771 Eligible

Instruction Medium: Nationality: India


Student's Name: SONAWANE BHAGYASHREE MANISH Mother's Name: PALLAVI Gender: Female
Name in Vernacular Language:  Ȫ“Žȯ—ȡʙĮȢ˜“ȢŸ
Address: G N 83 P NO 15 4 KALYANI NAGAR
City: JALGAON, Taluka: Jalgaon, District: Jalgaon, State: Maharashtra, PIN: 425001
Telephone no.: Mobile no: 919545365597 Email : bhagyashreesonawane101299@gmail.com
DOB: Dec 10, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117620
2017015400335715 Eligible

Instruction Medium: Nationality: India


Student's Name: CHAVAN NIKHIL TUKARAM Mother's Name: SHAILABAI Gender: Male
Name in Vernacular Language: …å¡ȡŽǓ“ͨ›Ǖ€ȡšȡ˜
Address: SANE GURUJI COLONY HIVARKHEDA ROAD
City: JAMNER, Taluka: Jamner, District: Jalgaon, State: Maharashtra, PIN: 424206
Telephone no.: Mobile no: 9172279007 Email :
DOB: Sep 16, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117621
2017015400361152 Eligible

Instruction Medium: Nationality: India


Student's Name: JADHAV GAYATREE RAMESH Mother's Name: PALLAVI Gender: Female
Name in Vernacular Language: ‡ȡ’‚ȡ™ğȢš˜ȯž
Address: 6 BALAJI COLONY NAKANE RD
City: DHULE, Taluka: Dhule, District: Dhule, State: Maharashtra, PIN: 424001
Telephone no.: Mobile no: 9767569059 Email : gaujadhav2608@gmail.com
DOB: Aug 26, 1999 Category: Reserved (SBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117622
2017015400364073 Eligible

Instruction Medium: Nationality: India


Student's Name: KULKARNI JANHAVI DINESH Mother's Name: ROHINI Gender: Female
Name in Vernacular Language: KULKARNI JANHAVI Ǒ‘“ȯž
Address: KHEDE
City: KHEDE, Taluka: Dhule, District: Dhule, State: Maharashtra, PIN: 424302
Telephone no.: Mobile no: 9403336883 Email : janhavidk99@gmail.com
DOB: Nov 14, 1999 Category: Open Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117623
2017015400386223 Eligible

Instruction Medium: Nationality: India


Student's Name: PATEL SHOEAB SHARIF Mother's Name: SHABANA Gender: Male
Name in Vernacular Language: ”Šȯ›žȪf–žšȣ•
Address: PATEL COLONY
City: KORPAWALI, Taluka: Yaval, District: Jalgaon, State: Maharashtra, PIN: 425301
Telephone no.: Mobile no: 9730601395 Email : shoeabpatel2424@gmail.com
DOB: Apr 24, 1999 Category: Open Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117624
2017015400386246 Eligible

Instruction Medium: Nationality: India


Student's Name: CHOPADE PUJA SANJEEV Mother's Name: MINAKSHI Gender: Female
Name in Vernacular Language: …Ȫ”°ȯ”Ǘ‡ȡ Ȳ‡Ȣ
Address: NHAVI
City: NHAVI, Taluka: Yaval, District: Jalgaon, State: Maharashtra, PIN: 425503
Telephone no.: Mobile no: 918806015269 Email :
DOB: Aug 26, 1998 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117625
2017015400387733 Eligible

Instruction Medium: Nationality: India


Student's Name: BARI ANIKET PRABHAKAR Mother's Name: RANJANA Gender: Male
Name in Vernacular Language: –ȡšȣ\Ǔ“€ȯĤ—ȡ€š
Address: BARI WADA
City: RAVER, Taluka: Jalgaon, District: Jalgaon, State: Maharashtra, PIN: 425508
Telephone no.: Mobile no: 919657133886 Email :
DOB: Feb 05, 2000 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117626
2017015400395817 Eligible

Instruction Medium: Nationality: India


Student's Name: CHITTE VISHAL DILIP Mother's Name: LALITA Gender: Male
Name in Vernacular Language: CHITTE VISHAL DILIP
Address: BALAJI NAGAR SHINGAVE ROAD
City: SHIRPUR, Taluka: Shirpur, District: Dhule, State: Maharashtra, PIN: 425405
Telephone no.: Mobile no: 917038170804 Email :
DOB: Nov 09, 1998 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117627
2020015400265172 Eligible

Instruction Medium: English Nationality: India


Student's Name: NARKHEDE NIRMALA BALKRUSHNA Mother's Name: SULOCHANA Gender: Female
Name in Vernacular Language: Ǔ“˜[›ȡ–ȡœ€Ǚ玓ȡšȯŒȯ
Address: DIPAK NAGAR STREET NO 2 MALKAPUR
City: MALKAPUR, Taluka: Malkapur, District: Buldhana, State: Maharashtra, PIN: 443101
Telephone no.: Mobile no: 918600379714 Email : nirmalanarkhede99@gmail.com
DOB: Jul 23, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117628
2020015400273941 Eligible

Instruction Medium: Nationality: India


Student's Name: VERMA SAYUJ KAILASH VERMA Mother's Name: HANSA VERMA Gender: Male
Name in Vernacular Language:  ȡ™Ǖ‡€Ȱ›ȡ ˜ȡ[
Address: Kahanar Toli Near Powar Boarding Gondia Kahanar Toli Gondia
City: Gondia, Taluka: Gondia, District: Gondiya, State: Maharashtra, PIN: 441614
Telephone no.: Mobile no: 919503195644 Email : sayujverma007@gmail.com
DOB: Oct 05, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117629
2020015400273956 Eligible

Instruction Medium: Nationality: India


Student's Name: PRAJAPATI SURAJ RADHESHYAM Mother's Name: SUNEETA Gender: Male
Name in Vernacular Language:  Ǘš‡Ĥ‡ȡ”Ǔ
Address: House No 36 Jalalpur Mittupur Road Rampur Chandidiha Post Bhaukuan
City: Jalalpur, Taluka: Jalalpur, District: Ambedkar Nagar, State: Uttar Pradesh, PIN: 224149
Telephone no.: Mobile no: 917388806015 Email : Surajprajapati2174292@gmail.com
DOB: Jul 18, 2001 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117630
2020015400273964 Eligible

Instruction Medium: Nationality: India


Student's Name: YEOLE ANIKET SHARAD Mother's Name: SHALINI Gender: Male
Name in Vernacular Language: \Ǔ“€ȯžš‘™ȯ›ȯ
Address: At Kapri Kene Po Paradsinga Ta Narkhed Dist Nagpur Khapri Kene
City: Narkhed, Taluka: Narkhed, District: Nagpur, State: Maharashtra, PIN: 441305
Telephone no.: Mobile no: 917028848285 Email : aniketyeole121@gmail.com
DOB: Mar 08, 2000 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117631
2020015400273972 Eligible

Instruction Medium: Nationality: India


Student's Name: BHOITE MOHINI SANJAY Mother's Name: HEMA Gender: Female
Name in Vernacular Language: ˜ȪǑ¡“Ȣ Ȳ‡™—Ȫ_Šȯ
Address: Shivaji Nagar Malkapur Shivaji Nagar Malkapur Malkapur
City: Malkapur, Taluka: Malkapur, District: Buldhana, State: Maharashtra, PIN: 443101
Telephone no.: Mobile no: 919422559680 Email : mohinia8484@gmail.com
DOB: Jun 21, 1999 Category: Open Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117632
2020015400273987 Eligible

Instruction Medium: Nationality: India


Student's Name: SARODE SHUBHAM SURESH Mother's Name: TARABAI Gender: Male
Name in Vernacular Language:  šȪ‘ȯžǕ—˜ Ǖšȯž
Address: Ward No 03 Ambada Deshmukh Ambada Deshmukh
City: Yenikoni, Taluka: Narkhed, District: Nagpur, State: Maharashtra, PIN: 441306
Telephone no.: Mobile no: 8605234316 Email : shubhamsarode435@gmail.com
DOB: Jun 07, 1999 Category: Reserved (SC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117633
2020015400273995 Eligible

Instruction Medium: Nationality: India


Student's Name: INGLE ABHAYKUMAR MANOHAR Mother's Name: SAVITA Gender: Male
Name in Vernacular Language: \—™€Ǖ˜ȡš˜“Ȫ¡š^Ȳ‚œȯ
Address: At Kadmapur Post Loni Gurao Tqkhamgaon Dist Buldhana Kadmapur
City: Buldhana, Taluka: Khamgaon, District: Buldhana, State: Maharashtra, PIN: 444303
Telephone no.: Mobile no: 919145227230 Email : abhaymingle230@gmail.com
DOB: Jan 19, 1996 Category: Reserved (SC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117634
2020015400274004 Eligible

Instruction Medium: Nationality: India


Student's Name: GHYAR VAIBHAV SANTOSH Mother's Name: VIJAYABAI Gender: Male
Name in Vernacular Language: ˙ȡšȰ— ȲȪŸ
Address: Holy Place Hivarkheda Road Jamner Jamner
City: Jamner, Taluka: Jamner, District: Jalgaon, State: Maharashtra, PIN: 424206
Telephone no.: Mobile no: 918605518223 Email : ghyarvaibhav@gmail.com
DOB: Jul 11, 1998 Category: Reserved (NT-3 (NT-D)) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117635
2020015400276123 Eligible

Instruction Medium: Nationality: India


Student's Name: DALVI RAMPRASAD SUDHAKAR Mother's Name: REKHA Gender: Male
Name in Vernacular Language: ‘œȢšȡ˜Ĥ ȡ‘ Ǖ’ȡ€š
Address: At Post Hiwara Ashram Hiwara Ashram
City: Hiwara Ashram, Taluka: Mehekar, District: Buldhana, State: Maharashtra, PIN: 443301
Telephone no.: Mobile no: 917219800963 Email : ramprasaddalvi6@gmail.com
DOB: Oct 06, 1998 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117636
2020015400280546 Eligible

Instruction Medium: Nationality: India


Student's Name: PADGHAN AKSHAY BABAN Mother's Name: USHA Gender: Male
Name in Vernacular Language: \¢™––“”Œƒȡ“
Address: At Jumda Post Sawar Gaon Jire Tal Washim Dist Washim Sawar Gaon Jire
City: Washim, Taluka: Washim, District: Washim, State: Maharashtra, PIN: 444505
Telephone no.: Mobile no: 919665499801 Email : padghan.akshay11@gmail.com
DOB: Nov 05, 1997 Category: Reserved (SC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117637
2020015400283301 Eligible

Instruction Medium: Nationality: India


Student's Name: ANIKET RAJ Mother's Name: KIRAN KUMARI Gender: Male
Name in Vernacular Language: \Ǔ“€ȯšȡ‡
Address: Nakhas Mangal Akhara Near Begumpur Post Office Patna City
City: Patna , Taluka: Patna Sadar, District: , State: Bihar, PIN: 800009
Telephone no.: Mobile no: 917979970663 Email : aniketraaj0101@gmail.com
DOB: Dec 15, 1999 Category: Open Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117638
2020015400283316 Eligible

Instruction Medium: Nationality: India


Student's Name: NISHANT KUMAR Mother's Name: MANJU DEVI Gender: Male
Name in Vernacular Language: Ǔ“žȡȲ€Ǖ˜ȡš
Address: Manpur Bairiya Bairiya Bairiya
City: Patna, Taluka: Patna Sadar, District: Patna, State: Bihar, PIN: 800007
Telephone no.: Mobile no: 917765958354 Email : nishantkumarr010@gmail.com
DOB: Dec 06, 1999 Category: Reserved (OBC) Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117639
2020015400283982 Eligible

Instruction Medium: Nationality: India


Student's Name: BHONDEKAR BHAGYASHRI SHANTARAM Mother's Name: MANGALA Gender: Female
Name in Vernacular Language: —ȡʙĮȢžȡȲȡšȡ˜—ɉŒȯ€ȡš
Address: At Tikodi Post Naigaon Tikodi Tikodi
City: Tikodi, Taluka: Nandura, District: Buldhana, State: Maharashtra, PIN: 443404
Telephone no.: Mobile no: 917721873806 Email : bhagyasribhondekar@gmail.com
DOB: May 07, 1999 Category: Open Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp
Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon
http://nmuj.digitaluniversity.ac/

School of Computer Sciences (10000G)


Application Form for Examination of May-2022 event.

M.C.A.(with Credits) - Regular - under CBCS [June-2020] Pattern - M.C.A. Part-II - Sem-IV
To explore your personalized Job Opportunities, Competitive Exams, Career Fairs etc., click on 'EASY' link in your 'e-Suvidha' account on
http://nmuj.digitaluniversity.ac/. Activate your 'e-Suvidha' account and login today!

PRN: Eligibility Status: Examination form No.:


117640
2020015400284246 Eligible

Instruction Medium: Nationality: India


Student's Name: SAMAIRA Mother's Name: BABY KUMARI Gender: Female
Name in Vernacular Language:  ˜Ȱšȡ
Address: C O Akhileshwar Prasad Singh North Of Balty Factory Shyam Nagar Jehanabad
City: Jehanabad, Taluka: Jehanabad, District: Jehanabad, State: Bihar, PIN: 804408
Telephone no.: Mobile no: 919523505219 Email : samaira8299@gmail.com
DOB: Feb 08, 1999 Category: Open Physically Handicap: No
Important: You will be allowed to appear for only those Paper which you have marked. Please mark carefully. NA: Not Applicable, NS: Not Scheduled for this event, M: Excluded from
appearing in this event
1. Sem-IV(Regular-under CBCS [June-2020] Pattern-
No Branch) Division : NA ,Roll Number : NA
Paper Details: Please select Paper details which you want to appear ( UA - University Assessment,CA - College Assessment ) Inward Status: Not Inward
SN Paper Code Paper Name AM - AT
1 251401 CA-401 Full time Industrial Training PJ-UA [ ]
Center Preference (Code/Name):
Venue Preference (Code/Name):

Fee Head 1 2 3 4 5 6 7 8
CAP Fee
Environment Fee
Exam Fee
Exam Form Fee
Exam Form Late Fee
Exam Form Super Late Fee
Exam Form Super Late(Per Day) Fee
General Knowledge Fee
Other Fee
Passing Certificate Fee
Practical Fee
Project Viva Fee
Statement of Marks Fee
Sub Total:
Payment Details: Amount Received: College Receipt No. and Date:
DD No: MICR No: DD Date: Bank:
To, Director,Board of Examination and Evaluations / The Controller Of Examination, Place:
I request permission to present myself for the ensuing examination. I have remitted the prescribed fee for the same. I hereby declare that all
statement made in this application are true, complete and correct to the best of my knowledge and belief. I have gone through the syllabus and Date:
the list of books prescribed for the examination for which I am appearing. I shall not request for any special concession such as change in time
or day fixed for university Examination etc. on religious or any other ground. I understand that in the event of any information being found false
or incorrect, my candidature is liable to be cancelled or rejected.

Student's Signature
Declaration by Principal/HOD/Chairperson
This form is carefully scrutinized by the College staff and by me. The information printed in the form is correct to the best of my knowledge. I also undertake the responsibility of
fulfillment/rectification of the information. He/she is regular student of this College and has completed the required attendance and practical course/term work (if any) according to university
rules.

Place:

Date:
College Staff Signature Seal and Signature of
Principal/HOD/Chairperson
Form Generated on: by Prashant Shitole, Form Downloaded on: Friday, March 25, 2022, 8:56:08 PM by amolp

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