STUDENT COPY

YCMOU MCA Study Centre (54491)

Application No :
Yashwantrao Chavan Maharashtra Open University
Dnyangangotri Near Gangapur Dam, Nashik, Pin Code-422222, Maharashtra(India)
44710
Academic Year: 2023-2024 Distance Education
ADMISSION FORM

Course Applied for : P131 - B.C.A.(with Credits) - Distance Education

- 2016 CGPA - T.Y.B.C.A Semester V (P131)
PRN:2021017000005627

Application Date : 10/07/2023 Payment Category : 8

Exam Center Name [Code] : - [-]
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed
TADVI MATEEN NABAB
on School leaving/Passing
[*This name will appear on all University records/documents]
Certificate :
Mother's
Father's/Husband's Name : NABAB MEENA
Name :
Mother
Marital Status : Married
Tongue :
Place Of Birth : Nashik Gender : Male Date of Birth (DD/MM/YYYY) : 05/01/1990
Blood Group : Religion : Country of Citizenship : India
Weight : Not
Height : Not Available Hemoglobin : Not Available
Available
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Nashik Tehsil : Nashik City/Town/Village :
Available
Address (House
no,street/area/suburb 19, Gitganga Society Saptashrungi Nagar, Jail Road Old Saikheda Road Pin Code : 422101
etc.) :
Contact details
Mobile
8177962890 Primary Email ID: matintadvi5@gmail.com
Number
2.Legal Reservation Information
Category Type :
Category : ST
Reserved
Is Guardian from EBC (Economic
Is Specially Abled? No
Backward Class)? No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Semester V
CMP332 - Quantitative Aptitude CMP513 - E Commerce Technologies
CMP514 - Advance Java CMP515 - Linux Administration
CMP713 - Lab: E Commerce Technologies CMP714 - Lab: Advance Java
CMP715 - Lab: Linux Administration
Semester VI

CMP516 - Android Programming CMP517 - PHP Programming

CMP716 - Lab: Android Programming CMP717 - Lab: PHP Programming
CMP801 - Project-BCA OPN273 - Personality And Career Skills

Medium of Instruction : English

Admission Fee Payment
Fee Category : Regular Fees Over All Payment Status: : Paid
Details
Sports Fees(N) - 50 NSS Fees(N) - 10
Disaster Management Fees(N) - 10 Chancellor Office Events Fees(N) - 38
Registration Fee(N) - 200 Eligibility Fees(N) - 0
Identity Card Fees(N) - 0 E-Suvidha / E-Services Fees(N) - 60
Library Fee(N) - 10 DSW Fees(N) - 50
Alumni Fees(N) - 10 Sanvad Fees(N) - 10
Graduation/Convocation Fees(N) - 350 Student Insurance Fees(N) - 10
Tuition Fees(N) - 6202 Adm Examination Fees(N) - 2830
Prospectus Fees(N) - 50 Tuition Fees(LSC - 3rd Year)(N) - 10000
Total : 19890
Payment
Amount Transaction Date Transaction Number Transaction Type
Status
19890 Paid 31/07/2023 00:00:00 2001690827290926 Online Payment
4.Guardian Information
Occupation of Guardian : Annual Income of Guardian : 0
5.Educational Details
Name of Month and Exam
Name of Name of Certificate Mark
Board/University and Year of Seat Out Of CGPA %
Examination School/College No. Obtained
State of University Passing No.
MAHARASHTRA STATE
BOARD OF SECONDARY
Std 10th AND HIGHER March 2005 -- -- 456.00 750.00 -- - -- 60.80
SECONDARY
EDUCATION,
Diploma :
Computer Tilak Maharashtra
May 2010 -- -- 1591.00 2450.00 -- - -- 64.94
Engineering Vidyapeeth
Diploma
Degree :
Preparatory
(Eng.Med.)(With December -- -
-- -- 73.00 100.00 73.00
Credits)-Distance 2021 First
Education-2004
Pattern
Your Last Qualifying Exam:
7.Other Information
Would you like to apply for Hostel accommodation required NA
Required Documents and Certificates Section:
Statement of Marks of Qualifying Exam (पात्रता परीक्षेची गुण पत्रिका)

Passing Certificate of Std 10th.

Leaving Certificate.

Domicile Certificate.

Statement of Marks of First Year/ Semester

Statement of Marks of Second Year/ Semester

Statement of Marks of Std 10th

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 )
[STUDY CENTER COPY]

YCMOU MCA Study Centre (54491)

Application No :
Yashwantrao Chavan Maharashtra Open University 44710
Dnyangangotri Near Gangapur Dam, Nashik, Pin Code-422222, Maharashtra(India)
Academic Year: 2023-2024 Distance Education
ADMISSION FORM

Course Applied for : P131 - B.C.A.(with Credits) - Distance Education PRN:2021017000005627

- 2016 CGPA - T.Y.B.C.A Semester V (P131)

Application Date : 10/07/2023 Payment Category : 8

Exam Center Name [Code] : - [-]
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed
TADVI MATEEN NABAB
on School leaving/Passing
[*This name will appear on all University records/documents]
Certificate :
Mother's
Father's/Husband's Name : NABAB MEENA
Name :
Mother
Marital Status : Married
Tongue :
Place Of Birth : Nashik Gender : Male Date of Birth (DD/MM/YYYY) : 05/01/1990
Blood Group : Religion : Country of Citizenship : India
Weight : Not
Height : Not Available Hemoglobin : Not Available
Available
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Nashik Tehsil : Nashik City/Town/Village :
Available
Address (House
no,street/area/suburb 19, Gitganga Society Saptashrungi Nagar, Jail Road Old Saikheda Road Pin Code : 422101
etc.) :
Contact details
Mobile
8177962890 Primary Email ID: matintadvi5@gmail.com
Number
2.Legal Reservation Information
Category Type :
Category : ST
Reserved
Is Guardian from EBC (Economic
Is Specially Abled? No
Backward Class)? No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Semester V
CMP332 - Quantitative Aptitude CMP513 - E Commerce Technologies
CMP514 - Advance Java CMP515 - Linux Administration
CMP713 - Lab: E Commerce Technologies CMP714 - Lab: Advance Java
CMP715 - Lab: Linux Administration
Semester VI

CMP516 - Android Programming CMP517 - PHP Programming

CMP716 - Lab: Android Programming CMP717 - Lab: PHP Programming
CMP801 - Project-BCA OPN273 - Personality And Career Skills

Medium of Instruction : English

Admission Fee Payment
Fee Category : Regular Fees Over All Payment Status: : Paid
Details
Sports Fees(N) - 50 NSS Fees(N) - 10
Disaster Management Fees(N) - 10 Chancellor Office Events Fees(N) - 38
Registration Fee(N) - 200 Eligibility Fees(N) - 0
Identity Card Fees(N) - 0 E-Suvidha / E-Services Fees(N) - 60
Library Fee(N) - 10 DSW Fees(N) - 50
Alumni Fees(N) - 10 Sanvad Fees(N) - 10
Graduation/Convocation Fees(N) - 350 Student Insurance Fees(N) - 10
Tuition Fees(N) - 6202 Adm Examination Fees(N) - 2830
Prospectus Fees(N) - 50 Tuition Fees(LSC - 3rd Year)(N) - 10000
Total : 19890
Payment
Amount Transaction Date Transaction Number Transaction Type
Status
19890 Paid 31/07/2023 00:00:00 2001690827290926 Online Payment
4.Guardian Information
Occupation of Guardian : Annual Income of Guardian : 0
5.Educational Details
Name of Month and Exam
Name of Name of Certificate Mark
Board/University and Year of Seat Out Of CGPA %
Examination School/College No. Obtained
State of University Passing No.
MAHARASHTRA STATE
BOARD OF SECONDARY
Std 10th AND HIGHER March 2005 -- -- 456.00 750.00 -- - -- 60.80
SECONDARY
EDUCATION,
Diploma :
Computer Tilak Maharashtra
May 2010 -- -- 1591.00 2450.00 -- - -- 64.94
Engineering Vidyapeeth
Diploma
Degree :
Preparatory
(Eng.Med.)(With December -- -
-- -- 73.00 100.00 73.00
Credits)-Distance 2021 First
Education-2004
Pattern
Your Last Qualifying Exam:
7.Other Information
Would you like to apply for Hostel accommodation required NA
Required Documents and Certificates Section:
Statement of Marks of Qualifying Exam (पात्रता परीक्षेची गुण पत्रिका)

Passing Certificate of Std 10th.

Leaving Certificate.

Domicile Certificate.

Statement of Marks of First Year/ Semester

Statement of Marks of Second Year/ Semester

Statement of Marks of Std 10th

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 Sun Oct 29 2023 00:24:19 GMT+0530 (India Standard Time)