College Code: BVCH BHAVAN’S VIVEKANANDA COLLEGE OF SCIENCE, HUMANITIES AND COMMERCE ‘SAINIKPURI, SECUNDERABAD- 500 094. ‘Application No. BCA-1SEMII72 ‘Course Applied for : BCA SEM Subject Preferences : Date of Registration : 12/07/2022 Registration No.: 1930994 1. Personal Information ‘Name of the Student : ‘ASKANI MEGHANA, Father's Name : "AKURUMAIAH ‘Mother's Name :AJAVA Marital Status = Native Place : KOLLAPUR NAGARKURNOOL DIST Date of Birth: 08/05/2003 Gender : FEMALE Place of Birth: Blood Group: Religion : HINDU Medium : ENGLISH ‘Adhaar Card No. : 344089835140 Nationality: INDIAN Minority : NO 2. Address Details ‘Address for Correspondence : | VARIDVALA, KOLLAPUR, NAGARKURNOOL DIST Pin Code : 09102 ‘State : TELANGANA, District : NAGARKURNOOL, City : KOLLAPUR Permanent Address \VARIDYALA, KOLLAPUR, NAGARKURNOOL DIST ‘State : TELANGANA District : NAGARKURNOOL City : KOLLAPUR 3. Contact Details ‘Student's Mobile No, 9490076143 Parent's Mobile No, : 9490076143 ‘Student's Email i :askankurumaiah @gmail.com 4. Legal Reservation information Domicile state : TELANGANA ‘Caste Category : BC-D Phy. Handicapped : 5. Details of the Qualifying Exam Name of the Qualifying Exam : TSBIE Collegetschooo! Marks | Total Year ot | Education Attended Boardiuniversity | state | obtained | marks | Percentage | Passing ap | copa SRI CHAITANYA TSBIE RANGA 952 11000 952 2020 yes ° SUNIOR KALASALA REDDY6. Documents attached SrNo. Name of the DocumentiCertfcate 2 | MARKSHEET OF 12TH OR INTERMEDIATE 2 | aoTHcLass cermiFicaTe 3 | CASTE CERTIFICATE(ISSUED BY GOVT, OF TELANGANA) 4 | any OTHER RELEVANT DOCUMENTS. 5 | BONAFIDE CERTIFICATE 6 | AaDHaaR CARD 7. Parent's | Guardian's information| Parent's/ Guardian's Name : AKURUMAIAH ‘Occupation ofthe Parent / Guardian : GOVERNMENT EMPLOYEE ‘Annual Income of the Parent / Guardian : 1000000.00 Relationship ofthe Guardian with the Applicant : Father PParent's/Guardian’s Phone No, : 9490076143 ‘8. Other Information Mother Tongue : TELUGU Employment Status : NO Do you wish to join NCC / NSS: NO Hobbies, Proficiency and Other Interests : NA Participation in Games and Sports Personal identification Mark 1 : A MOLE ON THE FOREHEAD Personal ldenification Mark 2: A MOLE ON THE LEFT ARM Q. Do you want to join BSG (Bharat Scouts and Guides) ? A.No (Q. Do you want to join NCC? Ayes ‘Q. Do you want to join NSS? A.No 9. Declaration by the Student I hereby declare that, | have read the rules related to admission and the information filed in by me in this form is accurate and true to the best of my knowledge. | will be responsible for any aiscrepancy, arising out of the form signed by me and | undertake that, in absence of any document the final admission will not be granted and J ‘or admission stands cancelled. Place : KOLLAPUR NAGARKURNOOL DIST Date : 16/07/2022 Signature of Student10. Declaration by the Parent | Guardian | have permitted my son / daughter / ward to jin your college.The information supplied by him / her is correct to the best of my knowiedge. | have acquainted myself with the rules and fees of my son f daughter / ‘ward and will ensure that he / she abides by them | will be responsible for any discrepancy, arising out ofthe form signed by me and | undertake that, in absence of any ‘document the final admission will not be granted and / or admission stands cancelled. Place : KOLLAPUR NAGARKURNOOL DIST Date : 16/07/2022 ‘Signature of the Parent/Guardian REMARKS OF THE ADMISSION COMMITTEE May be AdmitediRejected to Programee in Semester Last date of payment of fee s not paid, ‘Admission may be cancelled ithe fees is not paid by this date. ‘Signature of the Admission Committee Member Principal