Examination Form - Dec 2021 ( Conducted in March 2022 )

FORM NO 57

APPLICATION DATE 05 MAR 2022

PROGRAMME FYBSC HS

EXAM TERM I

PRN NO A202102060

ELIGIBILITY NO 12021032018

To
The P rincipal,
AIS S MS -CHMCT,
P une.

S ir/Madam,
I request permissio n t o present myself at t he examinat io n co urse, ment io ned belo w.

1. PERSONAL DET AILS

NAME OF T HE APPLICANT
MOTAR ADITYA KAMAL
MOT HER'S NAME
KAMAL
MOBILE NUMBER EMAIL GENDER
98 34708 411 adityamotar007@gmail.com MALE

CAT EGORY DIVYANG/LEARNING DISABLE

OPEN NO
MEDIUM OF INST RUCT ION
ENGLISH

RESIDENT IAL ADDRESS

SHANTAI APARTMENT , MHASKE WASTI , ALANDI ROAD , PUNE
ST AT E CIT Y PINCODE
411015

2. SUBJECT SELECT ED
S EM. S UBJECT CODE S UBJECT NAME T YPE
I CC-101 FOOD PRODUCTION - I (THEORY + PRACTICAL) IE

I CC-102 FOOD & BEVERAGE SERVICES - I (THEORY + PRACTICAL) IE

I CC-103 HOUSEKEEPING - I (THEORY + PRACTICAL) IE

I SEC-104 INTRODUCTION TO FRONT OFFICE (THEORY + PRACTICAL) IE

I AECC-105 ENVIRONMENT SCIENCE (THEORY) IE

I - PHYSICAL EDUCATION (GRADED) G

I - DEMOCRACY, ELECTION AND GOVERNANCE (GRADED) G

DECLARAT ION:
I hereby declare that I have gone through the Syllabus and the list of books prescribed for the examination for
which I am appearing. I SHALL B E RESPO NSIB LE for any errors and wrong or incomplete entries made by me in the
Examination form.
I shall not request for special concession such as change in the time and/or day fixed for the examination etc.on
religious or any other grounds.

Yours Faithfully

S ig n a t u r e o f t h e Ca n d id a t e

T he above student information is found correct and verified as per college record.

Place : Date : St a m p & Sig na t ure o f t he C o lleg e Aut ho rit y