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    Application For Admission To XIITH Science - 1 Session 2022-2023 Application No.:29 Kishinchand Chellaram Junior College

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    Omkar
    This document is an application for admission to class 11th science at Kishinchand Chellaram Junior College for the 2022-2023 session. It contains personal details of the applicant such as name, date of birth, address, family details, and academic details. The applicant, Atharva Shende, is seeking admission to the 11th standard science stream. The application also includes declarations signed by the student and guardian acknowledging the accuracy of the information and agreeing to abide by the college rules. It will be reviewed by the admission committee who may approve or reject the application.

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    Application For Admission To XIITH Science - 1 Session 2022-2023 Application No.:29 Kishinchand Chellaram Junior College

    Uploaded by

    Omkar
    27 views3 pages
    This document is an application for admission to class 11th science at Kishinchand Chellaram Junior College for the 2022-2023 session. It contains personal details of the applicant such as name, date of birth, address, family details, and academic details. The applicant, Atharva Shende, is seeking admission to the 11th standard science stream. The application also includes declarations signed by the student and guardian acknowledging the accuracy of the information and agreeing to abide by the college rules. It will be reviewed by the admission committee who may approve or reject the application.

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    This document is an application for admission to class 11th science at Kishinchand Chellaram Junior College for the 2022-2023 session. It contains personal details of the applicant such as name, date of birth, address, family details, and academic details. The applicant, Atharva Shende, is seeking admission to the 11th standard science stream. The application also includes declarations signed by the student and guardian acknowledging the accuracy of the information and agreeing to abide by the college rules. It will be reviewed by the admission committee who may approve or reject the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    27 views3 pages

    Application For Admission To XIITH Science - 1 Session 2022-2023 Application No.:29 Kishinchand Chellaram Junior College

    Uploaded by

    Omkar
    This document is an application for admission to class 11th science at Kishinchand Chellaram Junior College for the 2022-2023 session. It contains personal details of the applicant such as name, date of birth, address, family details, and academic details. The applicant, Atharva Shende, is seeking admission to the 11th standard science stream. The application also includes declarations signed by the student and guardian acknowledging the accuracy of the information and agreeing to abide by the college rules. It will be reviewed by the admission committee who may approve or reject the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    Session 2022-2023

    KISHINCHAND CHELLARAM Application for


    JUNIOR COLLEGE Admission to XIITH
    SCIENCE - 1
    Session 2022-2023
    VIDYASAGAR PRINCIPAL K.M. Application No. :29
    KUNDNANI CHOWK, 124, DINSHAW
    WACHHA ROAD, CHURCHGATE,
    MUMBAI 400020.

    Applicant's Personal Details

    Name of the Student Surname First name Father's name

    SHENDE ATHARVA TUSHAR

    Mother's Name MANISHA

    Student Name(HINDI)

    Date of Birth 21/12/2005 Place Of Birth MUMBAI

    Birth State MAHARASHTRA Birth District MUMBAI

    Birth Tehsil MUMBAI Voter Id

    Marital Status Blood Group A+

    Religion HINDU Gender MALE

    Nationality INDIAN Aadhaar card Number 526519505507

    Mother Tongue MARATHI Passport Number

    EID Number Employment Status Unemployed

    NCC/NSS NO Eligibility No.


    Caste Category OPEN Sub Caste Brahman

    Enrollment Number PRN Number


    Handicap NO Is Orphan NO

    Saral No. Udise No. 27230100739

    Student has a Desktop/ NO Student has internet NO


    Laptop/ Smart phone connectivity

    Municipal Ward

    Father's/Husband's Name TUSHAR

    Occupation CHARTERED ACCOUNTANT Gross Annual Income 0


    Mobile 9323534894

    Office Address

    Address of Correspondence

    Address 17 ,2ND FLR,MALINI BLOCKS,BEDEKAR SADAN, T.G.Path,


    GIRGAUM,CHARNI ROAD, MUMBAI - 400004

    State Maharashtra District MUMBAI

    Tehsil City/Town/Village MUMBAI

    Pincode 400004
    Permanent/Native Address

    Address 17 ,2ND FLR,MALINI BLOCKS,BEDEKAR SADAN, T.G.Path,


    GIRGAUM,CHARNI ROAD, MUMBAI - 400004

    State Maharashtra District MUMBAI

    Tehsil City/Town/Village MUMBAI

    Pincode 400004

    Contact Details

    Student Phone 8828064990 Parent's Phone

    Mobile 9323534894

    Email Id [email protected]

    Payment mode Offline

    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 XI TH SCIENCE - 1

    Sr.No. Subject Name Subject Type

    Group Name : ELEC/PCM

    1 ENGLISH COMPULSORY

    2 ENVIRONMENTAL EDUCATION COMPULSORY

    3 HEALTH & PHYSICAL EDUCATION COMPULSORY

    4 PHYSICS OPTIONAL

    5 CHEMISTRY OPTIONAL

    6 MATHS & STATS OPTIONAL

    7 ELECTRONICS -I OPTIONAL

    8 ELECTRONICS -II OPTIONAL


    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 : 24/05/2022 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 : 24/05/2022 Signature of the Guardian/Parent

    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 cancelled if the fees are not paid by this date.

    Principal Signature of Admission Committee

    Other Details

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