8/7/23, 3:47 PM Registration Form

Rayat Shikshan Sanstha's

S.M.JOSHI COLLEGE,HADAPSAR .
Affiliated to Savitribai Phule Pune University, Pune
Re-Accredited by NAAC with 'A' Grade with CGPA Of 3.09
Website : http://smjoshicollege.com | Email : rayatsmjoshicollege@rediffmail.com |
Phone : 020-26999001
Academic Year : 2023-2024

Admission Form - B.Sc - Second Year

Form No.: 6043 PRN No.: 2203016986

Course: B.Sc Year: Second Year

Student Name: CHAVAN PIYUSH PRADIP DOB: 14-Mar-2004

Aadhar No.: 845196412503 Nationality: Indian

Category: OPEN Fees Category: EBC NG Gender: Male

Religion: Hindu Caste: MARATHA

Address:

Student Mobile No.: 7798523791 Email ID:

Father's/Guardain's Name: PRADIP Mother Name:

Previous Qualification Marks

Total Marks Sem I 106 Total Marks Sem II 90 SGPA Sem I 0 Total Credit 0
Sem I

Out of Marks Sem 220 Out of Marks Sem II 220 SGPA Sem II 0 Total Credit 0
I Sem II

Percentage Sem I 48.18 Percentage Sem II 40.68 CGPA 0

Semester-III Compulsory Subject Semester-III Optional

Subject's

CBMI (---)
MARATHI (00)

Semester-IV Compulsory Subject Semester-IV Optional

Subject's

CBMI (00)
MARATHI (00)

Short term Course

Student Undertaking

ASSURANCE LETTER REGARDING ATTENDANCE

I, CHAVAN PIYUSH PRADIP. would like to seek admission in B.Sc Second Year. class in your college for the academic year 2023-
2024. I assure you that I will maintain my 80% attendance in both terms. I am also aware that if I will not be able to attend the
required days of the college, I will be disqualified to appear College / University examination or my name will be removed from
attendance catalogue. Also my admission will be cancelled and I will not have any complaint against any action taken by the college
in this regard.

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8/7/23, 3:47 PM Registration Form

(Signature of the student)

Name: PIYUSH PRADIP CHAVAN

Date: 07-08-2023

I, CHAVAN PIYUSH PRADIP From Class B.Sc wish to take admission for the Short-Term courseMARATHI in
Second Year for the academic year 2023-2024 so I request you to enroll my name for the above mentioned course.

ANTI RAGGING AFFIDAVIT BY THE STUDENT

1. I, CHAVAN PIYUSH PRADIP having been admitted to have received a copy of the UGC Regulations on Curbing the Menace of
Ragging in Higher Educational Institutions,2009,(hereinafter called the Regulations )carefully read and fully understood the
provisions contained in the said Regulations.
2. I have ,in particular ,perused clause 3 of the Regulations and am aware a to what constitutes ragging.
3. I have also, in particular ,perused clause 7 and clause 9.1 of the Regulations and am fully aware of the penal and administrative
action that is liable to be taken against me in case I am found guilty for abetting ragging ,actively or passively, or being part of a
conspiracy to promote ragging.
4. I hereby solemnly aver and undertake that I will not indulge in any behaviour or act that may be constituted as ragging under
clause 3 of the Regulations. I will not participate in or abet or propagate through any act of the commission or omission that may be
constituted as ragging under clause 3 of the Regulations.
5. I hereby affirm that, if found guilty of ragging ,I am liable for punishment according to clause 9.1 of the Regulations, without
prejudice to any other criminal action that may be taken against me under any penal law or any law for the time being in force. I
hereby declare that I have not been expelled or debarred from admission in any institution in the country on account of being found
guilty of, abetting or being part of a conspiracy to promote, ragging; and further affirm that, in case the declaration is found to be
untrue ,I am aware that my admission is liable to be cancelled.

(Signature of the student)

Name: CHAVAN PIYUSH PRADIP

Assurance / Undertaking for availing Scholarship / Freeship by Student

I, CHAVAN PIYUSH PRADIP ,taking admission in B.Sc Class for academic year 2023-2024. I belongs to and taking admission as a
Scholarship / Free ship student. As I had mentioned / whitened my category as in my admission form.I hereby assure / promise you
to fill the scholarship from in time with all the required documents. (Caste –certificate, Income certificate, cast-validity certificate etc.
whatever required

If I fails to fill the scholarship form in time, I know that my scholarship / freeship will not get the sectioned and in such case I hereby
give the written assurance to pay the full fees of the B.Sc class form my side as a paying student.

Date: 07-08-2023

Place: (Signature of the student)

For Office Use

Remark Verified by(Sign & Seal)

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