Session 2023-2024

FERGUSSON COLLEGE Application for

(AUTONOMOUS) Admission to
M.SC._COM
APP_SEM 3
Fergusson College Rd, Shivajinagar, Session 2023-2024
Pune, Maharashtra 411004 Application No. :
758964

Applicant's Personal Details

PAHU SHUBHAM KRUSHNA LAXMAN SUNITA KRUSHNA

Name of the Student
PAHU PAHU

Surname First name Father name Mother's Name

Student Name(HINDI)
Date of Birth 13/02/2001 Place Of Birth NASHIK
Birth State MAHARASHTRA Birth District Please Select

Birth Tehsil Voter Id

Marital Status Blood Group B+

Religion HINDU Gender MALE

Nationality INDIAN Aadhar card Number 654130163385

Mother Tongue Passport Number

EID Number Employment Status Unemployed

NCC/NSS NO Eligibility No. 12022162963

Caste Category ST Sub Caste
Enrollment Number PRN Number 2210246248
Handicap NOT APPLICABLE Is Orphan NO
Saral No. Udise No.
Scholarship No Scholarship Required

Father's/Husband's Name KRUSHNA LAXMAN PAHU

Occupation OTHER Gross Annual Income 50,000

Mobile 8421335038

Office Address

Address of Correspondence

Address Ramoshi gully,behind Durga mata mandir vadala gaon nashik

State Maharashtra District Nashik

Tehsil NASHIK City/Town/Village Nashik

Pincode 422001

Permanent/Native Address

Address Ramoshi gully,behind Durga mata mandir vadala gaon nashik

State Maharashtra District Nashik

Tehsil NASHIK City/Town/Village Nashik

Pincode 422001
Contact Details

Student Phone Parent Phone

Mobile 8551008406

Email Id shubham.pahu.sp@gmail.com

Payment mode Please pay at college counter

Last Exam Details

Exam Name Name of Board/University

Month Year

Roll Number Division

Marks Obtained Maximum Marks

Percentage Result

Exam Details

Sr.No. Course Name SGPA CGPA

1 M.SC._COM APP_SEM 1 7.33 7.17
2 M.SC._COM APP_SEM 2 7.00

Subject Details
Preference : 1 Group Name : ADVANCED WEB TECHNOLOGIES

ADVANCED JAVA (CSA5301)

SOFTWARE ENGINEERING AND UML (CSA5302)
COMPUTER APPLICATIONS PRACTICAL – IV (LAB BASED ON ADVANCED JAVA) (CSA5311)
PROJECT (CSA5312)
CYBER SECURITY II (XCS5300)
SKILL DEVELOPMENT II (XSD5300)
PROGRAMMING IN C++ (GENERAL ELECTIVE – III) (CSA5306)
DATA STRUCTURES (GENERAL ELECTIVE – III) (CSA5310)

Declaration by Student

I hereby declare that, I have read the rules related to admission and the information filled in by me in this form is accurate
and true to the best of my knowledge. I will be responsible for any discrepancy, arising out of the form signed by me and I undertake
that, in absence of any document the final admission will not be granted and / or admission will stand cancel.

Date : 30/06/2023 Signature of the Student

Declaration by Guardian / Parent

I have permitted my son / daughter / ward to join your college.The information supplied by him / her is correct to the best of
my knowledge. I have acquainted myself with the rules and fees, dues to my son / daughter / ward and see that he / she observes.

Date : 30/06/2023 Signature of the Guardian/Parent

 I have permitted my son / daughter / ward to join your college.The information supplied by him / her is correct to the best of
my knowledge. I have acquainted myself with the rules and fees, dues to my son / daughter / ward and see that he / she observes.

For College / Institute Use Only

Designation Remarks / Particulars /Recommendations Signature and Date

Admission Clerk

Admission Committee

Accountant / cashier

Registrar/Office
superintendent

REMARK OF THE ADMISSION COMMITTEE

May be admitted to Class ____________________________________________________ Section ________________

May be Rejected __________________________________________________________________________________
Last date of payment of fees _________________________________________________________________________
Admission may be canceled if the fees are not paid by this date.

Principal Signature of Admission Committee

Other Details

30/06/2023 11:06:06
 Undertaking
I SHUBHAM KRUSHNA PAHU , the undersigned was a student of Fergusson College Autonomous in the
year (mention your last academic year in Fergusson College)_______________________ and now seeking
admission for the academic year 2023-2024 for the course (mention course and year) M.SC._COM
APP_SEM 3. I understand that under the current circumstances of COVID-19, I will be admitted to the next
academic year with the condition that I shall clear all my backlogs (which in normal circumstances would
have made me ineligible for the said admission) before commencement of the next semester. I am aware
that if I fail to do so, my admission stands invalid/cancelled and I will not hold the college responsible for the
consequences of the same.

Signature and Full name of the Student:

SHUBHAM KRUSHNA PAHU

Date 30/06/2023

Place :

30/06/2023 11:06:06
पतत,

मम. पमचमरर

र न महमववदरमलर,
फररस

शशवमजजनगर, परणण ४११००४.

व जचज रककम खमतरमवर जमम झमलरमननतर महमववदरमलरमत जमम करणणबमबत..

ववषर : शशषरवत

मज / आमहम असण शलहहन दण तत कक, अनरसहचचत जमतजचरम पवगमरतजल ववदरमररमरनम दण णरमत रणणमररम भमरत सरकमर मरमटटकततर शशषरवत
व ज /

व ज / फफशशपचम अजर हण मज / आमहम सवत:

फफशशप शमळववणरमसमठठ शमसनमचरम सवर अटम व शतर मलम / आमहमलम ममनर आहण त. शशषरवत

शमसनमचरम https:mahadbtmahit.gov.in रम Website वर ऑनलमइन अजर भरन जमम झमलरमननतर तरमचज शलखखत पत (Hard Copy) महमववदरमलरमत

जमम करणरमचज पहणर जबमबदमरम ममझज / आमचज रमहमल सदर अजर महमववदरमलरमनण सममजकलरमण ववभमगमकडण परढमल कमरमरवमहमसमठठ ऑनलमईन

व ज व फफशशप सममजकलरमण ववभमगमकडहन नममनजहर झमलरमस फकवम ऑनलमईन अजर

र म रमटहलरमस व शशषरवत
पमठववलरमननतर तरममधरण कमहम तट

भरणरमचण ममझरमकडहन रमहहन गणलरमस रमचज सवर जबमबदमरम ममझज / आमचज रमहमल आखण महमववदरमलरमचण जण कमहम शरलक आहण तण मज पहणर

भरणरमस तरमर आहण रमबमबत ममझज / आमचज महमववदरमलरमचरम ववरतधजत कतणतजहम तकमर रमहणमर नमहम.

पवणश अजर भरतमनम महमववदरमलरमचरम Website वर Upload कणलणलरम अनरसहचचत जमतज पवगमरतजल ववदरमररमरनम दण णरमत रणणमररम भमरत सरकमर

व ज रतजनणसनदभमरतजल महमरमषट शमसनमचरम, समममजजक नरमर व ववशणष सहमयर ववभमगमचरम, शमसन तनणरर कममनक:
मरमटटकततर शशषरवत

भमसशज-२०२२/प. क ७४/शशकण-१ टद. १७ ममचर २०२२, मज / आमहम कमळजजपहवक

र परणप व ज /
र णण वमचलम आहण . रम शमसन तनणमररपममणण मज शशषरवत

फफशशपचम ऑनलमईन अजर भरलरमननतर मलम मनजहर झमलणलम रककम ममझरम खमतरमवर जमम झमलरमवर महमववदरमलरमस दण र असलणलम रककम

परढमल ७ टदवसमचरम आत महमववदरमलरमस जमम करण ल अशज हमज मज / आमहम रम पतमवदमरण दण त आहतत.

ववदरमररमरचरम वडडलमनचज / पमलकमनचज सहम ववदरमररमरचज सहम

ववदरमररमरचण सनपहणर नमव : _______________________________________________________

वगर ____________________________ तरकडज ________________ अनरदमतनत / ववनमअनरदमतनत

पतम : ____________________________________________________________________

________________________________________________________________________

पमलकमनचम मतबमईल नन. ____________________ ववदरमररमरचम मतबमईल नन. ____________________

30/06/2023 11:06:06
30/06/2023 11:06:06