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Ambedkar

1. This document is an application form for admission to M.Com program at Dr. Ambedkar College in Nagpur, India. 2. The applicant, Shital Gonnade, is providing personal details like name, date of birth, address, family details, educational qualifications and category for reservation. 3. The form requires details of past educational qualifications, marks obtained, income of guardian and other documents needed for admission process. 4. At the end, the applicant declares that all information provided is true and understands the policies on ragging and sexual harassment. The form needs to be printed and submitted to complete the admission process.

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Aditya Borkar
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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50 views5 pages

Ambedkar

1. This document is an application form for admission to M.Com program at Dr. Ambedkar College in Nagpur, India. 2. The applicant, Shital Gonnade, is providing personal details like name, date of birth, address, family details, educational qualifications and category for reservation. 3. The form requires details of past educational qualifications, marks obtained, income of guardian and other documents needed for admission process. 4. At the end, the applicant declares that all information provided is true and understands the policies on ragging and sexual harassment. The form needs to be printed and submitted to complete the admission process.

Uploaded by

Aditya Borkar
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

07/08/22, 2:30 AM

For Office Use


Batch: Scrutiny Payment: Online/DD PI

Serial:
Only

DR. AMBEDKAR COLLEGE (011) Application No


DIKSHABHOOMI Nagpur City
RASHTRASANT TUKADOJI MAHARAJ NAGPUR UNIVERSITY :
Chhatrapati Shivaji Maharaj Administrative Premises, Ravindranath Tagore Marg, Nagpur,MH.
(India)
242195
Academic Year: 2022-2023 Regular
APPLICATION FORM

Course Applied for : M.COM. R.T.M. Nagpur Uni.(with Credits) - Regular - REGULAR - F.Y.M.COM First Semester 
PRN:
(MCOM360)

Application Date : 07/08/2022 Payment Category :


Exam Center Name [Code] : - [-]
1.Personal Information
Candidate's Name(Regional) : गोन्नाडे शीतल नरेंद्र
Candidate's Name as printed on School GONNADE SHITAL NARENDRA
leaving/Passing Certificate : [*This name will appear on all University records/documents]
Father's/Husband's Name : NARENDRA Mother's Name : MANGALA
Mother Tongue
Marital Status !"!#$%& '()* : UnMarried Marathi
+#),-#.# :

Place Of Birth /0(#1 : Talodhi Gender 234 5 : Female Date of Birth /0)#6*7 (DD/MM/YYYY) : 30/07/1999

Blood Group 68 59 : ABPositive Religion :+; : Hindu Country of Citizenship 1#5<6&=#># ?@A : India
Height : Not Available Weight : Not Available Hemoglobin : Not Available
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
City/Town/Village : Talodhi
State 6#B : Maharashtra District : Chandrapur Tehsil : Nagbhid
Balapur
Location Area : Rural

Address (House
Ward No 7, Teacher Colony, Gaymukh Road Talodhi Balapur Pin Code : 441221
no,street/area/suburb etc.) :
Permanent Address :
City/Town/Village : Talodhi
State 6#B : Maharashtra District : Chandrapur Tehsil : Nagbhid Location Area : Rural
Balapur
Address : Ward No 7, Teacher Colony, Gaymukh Road Talodhi Balapur Pin Code : 441221
Contact details
Mobile Number 9834433185 Email ID C - +@3 DEF*: [email protected]
2.Legal Reservation Information
Category Type : Category /#)*># G&#6 :
Sub Category HI9/#)*># G&#6 : KOSHTI
Reserved SBC
Is Guardian from EBC (Economic Backward
Is Specially Abled? No
Class)?  No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
First Semester

Medium of Instruction :
Application Fee Payment Details Payment Status : Paid Transaction Date : -
Fee Category : With Registration Fee Rs. 20/- Transaction Type : - Transaction Number : -

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07/08/22, 2:30 AM

Registration Fees - 20 Total Amount : 20


4.Guardian Information
Occupation of Guardian H#3&#># J!K#E : Business Annual Income of Guardian H#3&#>@ !#L.M & NOP : 45000
5.Educational Details
Out
Month Of
Name of Name of Board/University and State of Name of Exam Certificate Mark
Obtained Q&RS
and Year CGPA %
Examination University School/College Seat No. No.
of Passing
5TS
MAHARASHTRA STATE BOARD OF
SECONDARY AND HIGHER LOK VIDYALAYA March
Std 10th J047597 047677 280.00 500.00 -- - -- 56.00
SECONDARY TALODHI BLAPUR 2015
EDUCATION,Maharashtra
MAHARASHTRA STATE BOARD OF
MAHATMA FULEY
Std 12th SECONDARY AND HIGHER February
VIDHYALAYA N150345 041114 312.00 650.00 -- - -- 48.00
Commerce SECONDARY 2017
JUNIOR COLLEGE
EDUCATION,Maharashtra
Degree : NEVJABAI
BACHELOR HITKARINI September 8.04 -
Gondwana University,Maharashtra 3917462 1388784 - - -
OF COLLEGE 2021 A
COMMERCE BRAMHAPURI
Your Last Qualifying Exam: BACHELOR OF COMMERCE
7.Other Information
Would you like to apply for Hostel accommodation required NA
Required Documents and Certificates Section:
Passing Certificate of Std 10th.

Passing Certificate of Std 12th / Statement of Marks of Std 12th./ Diploma

Leaving Certificate.

Certificate of Caste with Category.

Non Creamy Layer Certificate.

Domicile Certificate.

Caste Validity Certificate

Addhar Card copy

Degree MarkList/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 :242195 (GONNADE SHITAL NARENDRA) 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.
Note :- For further admission process print this application form and submit it to the college
KR>1# :- HTU*3 G!@A GLVE@K#W* E# X/#;>* %#F; &YH* (LG4 9 &YH* / Z#H*3 G))[# D\S )* +%#L!]#3E#) /+# &6#.

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

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07/08/22, 2:30 AM

[COLLEGE COPY]
For Office Use
Batch: Scrutiny Payment: Online/DD PI

Serial:
Only

DR. AMBEDKAR COLLEGE (011) Application No


DIKSHABHOOMI Nagpur City
RASHTRASANT TUKADOJI MAHARAJ NAGPUR UNIVERSITY :
Chhatrapati Shivaji Maharaj Administrative Premises, Ravindranath Tagore Marg, Nagpur,MH.
(India)
242195
Academic Year: 2022-2023 Regular
APPLICATION FORM

Course Applied for : M.COM. R.T.M. Nagpur Uni.(with Credits) - Regular - REGULAR - F.Y.M.COM First Semester 
PRN:
(MCOM360)

Application Date : 07/08/2022 Payment Category :


Exam Center Name [Code] : - [-]
1.Personal Information
Candidate's Name(Regional) : गोन्नाडे शीतल नरेंद्र
Candidate's Name as printed on School GONNADE SHITAL NARENDRA
leaving/Passing Certificate : [*This name will appear on all University records/documents]
Father's/Husband's Name : NARENDRA Mother's Name : MANGALA
Mother Tongue
Marital Status !"!#$%& '()* : UnMarried Marathi
+#),-#.# :

Place Of Birth /0(#1 : Talodhi Gender 234 5 : Female Date of Birth /0)#6*7 (DD/MM/YYYY) : 30/07/1999

Blood Group 68 59 : ABPositive Religion :+; : Hindu Country of Citizenship 1#5<6&=#># ?@A : India
Height : Not Available Weight : Not Available Hemoglobin : Not Available
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
City/Town/Village : Talodhi
State 6#B : Maharashtra District : Chandrapur Tehsil : Nagbhid
Balapur
Location Area : Rural

Address (House
Ward No 7, Teacher Colony, Gaymukh Road Talodhi Balapur Pin Code : 441221
no,street/area/suburb etc.) :
Permanent Address :
City/Town/Village : Talodhi
State 6#B : Maharashtra District : Chandrapur Tehsil : Nagbhid Location Area : Rural
Balapur
Address : Ward No 7, Teacher Colony, Gaymukh Road Talodhi Balapur Pin Code : 441221
Contact details
Mobile Number 9834433185 Email ID C - +@3 DEF*: [email protected]
2.Legal Reservation Information
Category Type : Category /#)*># G&#6 :
Sub Category HI9/#)*># G&#6 : KOSHTI
Reserved SBC
Is Guardian from EBC (Economic Backward
Is Specially Abled? No
Class)?  No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
First Semester

Medium of Instruction :
Application Fee Payment Details Payment Status : Paid Transaction Date : -

https://rtmnuoa.digitaluniversity.ac/ApplicationStatus/PrintApplication Page 3 of 5
07/08/22, 2:30 AM

Fee Category : With Registration Fee Rs. 20/- Transaction Type : - Transaction Number : -
Registration Fees - 20 Total Amount : 20
4.Guardian Information
Occupation of Guardian H#3&#># J!K#E : Business Annual Income of Guardian H#3&#>@ !#L.M & NOP : 45000
5.Educational Details
Out
Month Of
Name of Name of Board/University and State of Name of Exam Certificate Mark
Examination University School/College
and Year
Seat No. No. Obtained Q& R S CGPA %
of Passing
5TS
MAHARASHTRA STATE BOARD OF
SECONDARY AND HIGHER LOK VIDYALAYA March
Std 10th J047597 047677 280.00 500.00 -- - -- 56.00
SECONDARY TALODHI BLAPUR 2015
EDUCATION,Maharashtra
MAHARASHTRA STATE BOARD OF
MAHATMA FULEY
Std 12th SECONDARY AND HIGHER February
VIDHYALAYA N150345 041114 312.00 650.00 -- - -- 48.00
Commerce SECONDARY 2017
JUNIOR COLLEGE
EDUCATION,Maharashtra
Degree : NEVJABAI
BACHELOR HITKARINI September 8.04 -
Gondwana University,Maharashtra 3917462 1388784 - - -
OF COLLEGE 2021 A
COMMERCE BRAMHAPURI
Your Last Qualifying Exam: BACHELOR OF COMMERCE
7.Other Information
Would you like to apply for Hostel accommodation required NA
Required Documents and Certificates Section:
Passing Certificate of Std 10th.

Passing Certificate of Std 12th / Statement of Marks of Std 12th./ Diploma

Leaving Certificate.

Certificate of Caste with Category.

Non Creamy Layer Certificate.

Domicile Certificate.

Caste Validity Certificate

Addhar Card copy

Degree MarkList/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 :242195 (GONNADE SHITAL NARENDRA) 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.
Note :- For further admission process print this application form and submit it to the college
KR>1# :- HTU*3 G!@A GLVE@K#W* E# X/#;>* %#F; &YH* (LG4 9 &YH* / Z#H*3 G))[# D\S )* +%#L!]#3E#) /+# &6#.

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

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07/08/22, 2:30 AM

Document printed on Sun Aug 07 2022 02:30:09 GMT+0530 (IST)

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