Hostel Temporary Admission Form

Enrollment No : 2022/8229 - 06-February-2022 Acadamic Year : 2022-23

1. Laxmi Hostel, (Boys) Maharshi Nagar, For which period you want Febuary -
Hostel Name :
Swargate,Pune., admission? : March

Students Information - New

Students Full Name: Lukkad Yash Anil

Address : D2b vednagar
Taluka/City: Ujjain Dist. : Ujjain
Pin Code. : 456001 State : Madhya Pradesh
DOB : 03-November-1997 Blood Group : A+
Mobile No. : 8770093425 Email ID : yashlukkad@gmail.com
Aadhaar No. : Mothers Name : Snehlata jain

Educational Details of Last Year

Name of College/Educational
IIEBM
Institute:
Name of University : Pune University
Course/Degree : MBA Standard (which year) : First Year
Total Marks : 7.1 cg Obtained Mark : 7.1 cg
Percentage : 100% Specialization/Faculty Other

Educational Details of Current Year

Name of College/Educational Institute : Iiebm

Name of University : Pune University.
Course/Degree : MBA Standard (which year) : Second Year
Balance Course Duration : Specialization/Faculty : Other

Parents/Guardians Details

Parents/Guardians Full Name : Jain Anil

Address : .
Taluka/City : Ujjain Dist. : Ujjain
Pincode : 456001 State : Madhya Pradesh
Mobile No. : Email ID :

Bank Information of Student or Parent

Account Holders Name : Yash Lukkad

Account Type : Saving Account Account No. : 916010013350728
Bank IFSC Code : UTIB0000329 Bank Branch : Ujjain Madhya Pradesh
Bank Name : Axis Bank.
Bank Full Address : Hotel Ashray, Ground Floor, 77, Dewas Road, Ujjain.

Local Guardian Details (LG should be Maheshwari)

Full Name : Lukked Sawan Anil.

Spirea apartment bhumkar das road opposite Euro schoolSpirea apartment wing b F
Full Address :
1005
City : Pune Pin Code : 411057
Mobile No. : 7722071565 Email ID : sawanlukked@gmail.com
Attachments of Student Certificate