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B. K. Birla College: of Arts, Science and Commerce (Autonomous), KALYAN Affiliated To University of Mumbai

This document is an admission form for Aditi Mhatre to enroll in the 12th grade MCVC Accounting & Auditing class at B.K. Birla College of Arts, Science and Commerce in Kalyan, India. It collects personal details about Aditi such as name, date of birth, address, family details, previous academic results, subject preferences, and declarations signed by both the student and her father. Fees payment and required document attachments are also noted at the end.

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manoj phadtare
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472 views

B. K. Birla College: of Arts, Science and Commerce (Autonomous), KALYAN Affiliated To University of Mumbai

This document is an admission form for Aditi Mhatre to enroll in the 12th grade MCVC Accounting & Auditing class at B.K. Birla College of Arts, Science and Commerce in Kalyan, India. It collects personal details about Aditi such as name, date of birth, address, family details, previous academic results, subject preferences, and declarations signed by both the student and her father. Fees payment and required document attachments are also noted at the end.

Uploaded by

manoj phadtare
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Fees Receipt No. __________ Dt. _______________ Amt _______________ Form No.
40398

B. K. BIRLA COLLEGE
OF ARTS, SCIENCE AND COMMERCE
(Autonomous), KALYAN
Affiliated to University of Mumbai
ADMISSION FORM

XII MCVC(ACCOUNTING & AUDITING) (2021-2022) Division: _______

Roll No: ________


The Principal,
B. K. BIRLA COLLEGE OF ARTS, SCIENCE AND COMMERCE (Autonomous), KALYAN
Kalyan

I wish to apply for admission to the


XII MCVC(Accounting & Auditing)
 Class. I give below the necessary particulars.

Student Name
MHATRE
ADITI
TANAJI

Mother's Name
KANCHAN

Sex
Female
Aadhar Card No.
248105218385

Marital Status
Unmarried
Blood Group
A+

Date of Birth
21-Apr-2004
Place of Birth
KALYAN

Place of Birth's Taluka



Place of Birth's Dist

Place of Birth's State



Place of Birth's Country

Nationality
Indian
Mother Tongue
Marathi

Religion
Hindu
Category
OBC

Caste :
AGRI
SubCaste

Enrolled for Voter's List?


No

Correspondence Address GAONDEVI MANDIR NEAR DILIP KIRANA STORE MHARALGAON TAL KALYAN DIST

THANE - 421301

Native Place Address GAONDEVI MANDIR NEAR DILIP KIRANA STORE MHARALGAON TAL KALYAN DIST

THANE

Native District
THANE
Native State
Maharashtra

Telephone No. (Resi)

Student Mobile No.


9594918630
Guardian Mobile No.
8208369721

Student Email ID
[email protected]

Guardian Email ID

Physically Challenged
N/A

Subjects Offered
English


Environmental Science


Health & Physical Education


Hindi


Foundation Course


Advance Accounting I


Advance Accounting II


Advance Accounting III

Form No.
40398

Name of the Board / Mon. & Year Total Out of / Attempt


Examination Name of the College Seat No
University of Passing Marks Grade / SGPA

16.01.008-MARALESHWAR
SSC Maharashtra State Board MAR 2020 VIDYALAYA, MHARAL, KALYAN, A068866 398 500 1
DIST.THANE-

MAHARASHTRA STATE B.K. BIRLA COLLEGE (FORMERLY


XI APR 2021 9 436 600 --
BOARD BIRLA COLLEGE)

Parents / Guardian Details


Name
TANAJI MHATRE
Relationship
FATHER
Office Address
KALYAN
Occupation
SERVICE
Annual Income (Rs.)
96000

DECLARATION BY STUDENT
1. I hereby declare that I have read all the rules and regulations framed by the college authorities as given in the college prospectus,
which are presently in force.
2. I hereby declare and undertake to abide by all the mentioned rules and regulations and hereby agree, if admitted, to confirm to
them and to such other rules as may hereafter be made for the smooth functioning of the college.
3. I may not be granted terms or allowed to appear for the College / University Examination if my attendance in lectures and
tutorials / practicals falls short of 75%.
4. I may not be granted any concession in any matter, if I take up any employment during the course of my studies.
5. I hereby declare that I shall show satisfactory progress and maintain good conduct.
6. I hereby declare that I have not registered my name at any other institution for any other full time course.
7. I hereby declare that 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 cancelled.
8. I WILL DISPLAY MY IDENTITY CARD PROMINENTLY IN THE COLLEGE PREMISES.
9. I have given my and my parents most recent contact details (phone, email). In case of any change I undertake to inform college
accordingly.
10. I hereby give my consent for use of my contact details for educational communication.
11. I am aware that as per University Circular No. SW/42 of 2015 dtd. 29th Oct. 2015, I am compulsorily required to give an
undertaking on www.antiragging.in & www.amanmovement.org.
12. I will get myself enrolled for Voter ID Card when I would turn 18 Years of age.
13. I am aware that if eligible for Scholarship / Freeship scheme of Social Welfare Department then I must complete all formalities in
time. If I fail to do so then I undertake to pay full fees of course by end of October of the Current Academic year.
14. I have read eligibility conditions of University of Mumbai for my course. My admission will be confirmed subject to confirmation
from University of Mumbai

Date: 20-Jun-2021

(Signature of the Student)

DECLARATION BY PARENT / GUARDIAN


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 of my son / daughter / ward and to see that he / she observes, the
said rules in totality. I hereby give my consent for use of my contact details for educational communication.
Date: 20-Jun-2021

(Signature of the Parent / Guardian)

FEES PAYMENT INFORMATION


Order No:
--
Amount:
--
Status:
--
Bank Ref. No.:
--
PG Tracking No.:
--

NOTE: ATTACH THE PHOTOCOPY OF THE FOLLOWING DOCUMENTS AND CERTIFICATES


1. For F.Y.J.C. (XI) Admission - Marksheet of SSC.
2. For S.Y.J.C. (XII) Admission - Marksheet of SSC & F.Y.J.C. (XI)
3. Caste Certificate & Caste Validity Certificate (if any).
4. Address Proof (Aadhar Card / Passport / Electricity Bill / Telephone Bill)

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