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For Office Use

Batch: Scrutiny Payment: Online/DD PI

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Watumull Institute of Electronics Engineering and Computer Technology (368)

plot No. 157 CHM campus opp ulhasnagar Railway Station ulhasnagar Ulhasnagar
Application No :
University of Mumbai 2801410
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
Academic Year: 2022-2023
Regular
APPLICATION FORM

Course Applied for : B.E.(with Credits) - Regular - CBCS - Computer Engineering - S.E. C-Scheme Sem III PRN:
(BECBCS1001)

Application Date : 24/11/2022 Payment Category :

1.Personal Information

Candidate's Name(Regional) : नेवे गर्व राजेश

Candidate's Name as printed on Mark NEVE GARV RAJESH
sheet : [*This name will appear on all University records/documents]
Father's/Husband's Name : RAJESH Mother's Name : SARALA

Marital Status : UnMarried Mother Tongue : Marathi

Place Of Birth : Badlapur Gender : Male Date of Birth (DD/MM/YYYY) : 02/11/2003
Blood Group : APositive Religion : Hindu Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
City/Town/Village :
State : Maharashtra District : Thane Tehsil : Ambarnath Location Area : Urban
Badlapur
Address (House
F3 Suyog Sahajeevan CHS Old Katrap Road Badlapur Pin Code : 421503
no,street/area/suburb etc.) :
Permanent Address :
City/Town/Village :
State : Maharashtra District : Thane Tehsil : Ambarnath Location Area : Urban
Badlapur
Address : F3 Suyog Sahajeevan CHS Old Katrap Road Badlapur Pin Code : 421503
Contact details
Mobile Number 8976204830 Email ID: garv02112003@gmail.com
2.Legal Reservation Information
Category Type :
Category : OBC Sub Category : WANI
Reserved
Is Guardian from EBC (Economic Backward
Is Specially Abled? No
Class)? No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem III
CSC301 - Engineering Mathematics-III CSC302 - Discrete Structures and Graph Theory
CSC303 - Data Structure CSC304 - Digital Logic & Computer Architecture
CSC305 - Computer Graphics CSL301 - Data Structure Lab
CSL302 - Digital Logic & Computer Architecture Lab CSL303 - Computer Graphics Lab
CSL304 - Skill Base Lab Course: Object Oriented Programming With CSM301 - Mini Project – 1 A
Java
Sem IV

CSC401 - Engineering Mathematics-IV CSC402 - Analysis of Algorithm

CSC403 - Database Management System CSC404 - Operating System
CSC405 - Microprocessor CSL401 - Analysis of Algorithm Lab
CSL402 - Database Management System Lab CSL403 - Operating System Lab
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CSL404 - Microprocessor Lab CSL405 - Skill Base Lab Courses: Python Programming
CSM401 - Mini Project 1-B

Medium of Instruction : English

4.Guardian Information
Occupation of Guardian : Laborer Annual Income of Guardian : 90000
5.Educational Details
Month
Name of Name of Board/University and State of Name of Exam Certificate Mark
and Year Out of CGPA %
Examination University School/College Seat No. No. Obtained
of Passing
MAHARASHTRA STATE BOARD OF FATIMA HIGH
March
Std 10th SECONDARY AND HIGHER SCHOOL A077506 008673 378.00 500.00 -- - -- 75.60
2019
SECONDARY EDUCATION,Maharashtra BADLAPUR
Diploma : S.H. JONDHALE
Maharashtra State Board of Technical
Computer POLYTECHNIC July 2022 107449 -- 1415.00 1750.00 -- - -- 80.86
Education,Maharashtra
Engineering DOMBIVLI
Your Last Qualifying Exam: Computer Engineering
7.Other Information
Would you like to apply for Hostel accommodation required NA
Required Documents and Certificates Section:
Passing Certificate of Std 12th / Statement of Marks of Std 12th OR Original Passing Certificate /Statement of Marks of Last Qualifying Exam like
degree,diploma,etc.

Certificate of Caste with Category.

Passing Certificate of Std 10th.

Leaving Certificate.

Non Creamy Layer Certificate.

Domicile Certificate.

Death Certificate (If father/Mother is expired).

Domicile Certificate.

Non Creamy Layer Certificate.

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 Application No :2801410 (NEVE GARV RAJESH) 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 )
For College/Institute/Study Center Use Only
Designation Remarks / Particulars / Recommendations Signature and Date
Admission Clerk
Admission
Committee
Accountant/Cashier Cash Received: INR Receipt No.: Date:
Registrar/Office
Superintendent
Document printed on Thu Nov 24 2022 21:44:52 GMT+0530 (India Standard Time)

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