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Vishnu Waman Thakur Charitable Trust`s Viva College of Arts, Science and Application No
Commerce (548)
:
University of Mumbai
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
2142465
Academic Year: 2023-2024 Regular
APPLICATION FORM

Course Applied for : B.Sc. (I.T.)(with Credits) - Regular - Rev16 - T.Y. B.Sc. (I.T.) PRN:2021016402062722
Sem V [1S00255]  (42300003)

Application Date : 07/07/2023 Payment Category : 13

1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed on GUPTA ASHWIN AJAYKUMAR
Mark sheet : [*This name will appear on all University records/documents]
Father's/Husband's Name : AJAYKUMAR Mother's Name : USHA
Marital Status : UnMarried Mother Tongue :
Place Of Birth : SALEMPUR Gender : Male Date of Birth (DD/MM/YYYY) : 14/07/2003
Blood Group : Religion : Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Palghar Tehsil : Vasai City/Town/Village :
Available
Address (House
B/203, Datta Guru Apt, Sharda Nagar Virar Road, Nallasopara East Pin Code : 401209
no,street/area/suburb etc.) :
Contact details
Mobile Number 917558209452 Email ID: ashwingupta595@gmail.com
2.Legal Reservation Information
Category Type : Open Category : GEN
Is Guardian from EBC (Economic Backward
Is Specially Abled? No
Class)?  No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem V [1S00255]
53701 - Software Project Management 53702 - Internet of Things
53703 - Advanced Web Programming USIT5P1 - Project Dissertation
USIT5P2 - Internet of Things Practical USIT5P3 - Advanced Web Programming Practical
53705 - Linux System Administration USIT5P5 - Linux Administration Practical
53706 - Enterprise Java USIT5P6 - Enterprise Java Practical
Sem VI [1S00256]

88701 - Software Quality Assurance 88702 - Security in Computing

88703 - Business Intelligence USIT6P1 - Project Implementation
USIT6P2 - Security in Computing Practical USIT6P3 - Business Intelligence Practical
USIT6P6 - Advanced Mobile Programming 88705 - Enterprise Networking
USIT6P5 - Enterprise Networking Practical 88706 - IT Service Management

Medium of Instruction : English

4.Guardian Information
Occupation of Guardian : Service Annual Income of Guardian : 100000

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5.Educational Details
Month and Exam
Name of Name of Board/University and State Name of Certificate Mark
Year of Seat Out of CGPA %
Examination of University School/College No. Obtained
Passing No.
MAHARASHTRA STATE BOARD OF
Std 10th SECONDARY AND HIGHER March 2019 -- -- 304.00 500.00 -- - -- 60.80
SECONDARY EDUCATION,
MAHARASHTRA STATE BOARD OF
Std 12th 12Th
SECONDARY AND HIGHER August 2021 -- -- 456.00 600.00 -- - -- 76.00
(Science)
SECONDARY EDUCATION,
Your Last Qualifying Exam:
7.Other Information
Would you like to apply for Hostel accommodation required NA
DECLARATION
I hereby declare that all the information furnished by me in this application form is true, complete and correct to the best of my knowledge and belief. I do
understand that I need to obtain and produce all the required documents. I admit to having understood what constitutes ragging and sexual harassment. I
have read the guidelines related to the same. I hereby affirm that if found guilty of ragging or sexual harassment I am liable for punishment according to
the university regulations.

Place : Date  :
( Signature of the Candidate )
Document printed on Fri Jul 07 2023 19:58:41 GMT+0530 (India Standard Time)

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