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    For Office Use

    Batch: Scrutiny Payment: Online/DD PI

    Serial:
    Only

    Vidyavardhinis College of Engineering and Technology (466)


    Application No :
    University of Mumbai 510459
    M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
    Academic Year: 2024-2025 Regular
    APPLICATION FORM

    Course Applied for : B.E.(with Credits) - Regular - CBCS - Mechanical PRN:2021016402181442


    Engineering - T.E. C-Scheme Sem V (BECBCS1001)

    Application Date : 17/10/2024 Payment Category : 13


    1.Personal Information
    Candidate's Name(Regional) :
    Candidate's Name as printed HOLE MAITREYA RAJARAM
    on Mark sheet : [*This name will appear on all University records/documents]
    Mother's
    Father's/Husband's Name : RAJARAM YOGITA
    Name :
    Mother
    Marital Status : UnMarried
    Tongue :
    Place Of Birth : AHAMADNAGAR Gender : Male Date of Birth (DD/MM/YYYY) : 05/12/2002
    Blood Group : Religion : Country of Citizenship : India
    Is Student NRI/ Foreign National : No Domicile State: Maharashtra
    Address For Correspondence :
    Location Area : Not
    State : Maharashtra District : Palghar Tehsil : Vasai City/Town/Village :
    Available
    Address (House
    B-2/303, MATRU JOYT, CHHEDA ENCLAVE, PATANAKAR PARK, NALASOPARA
    no,street/area/suburb Pin Code : 401203
    WEST
    etc.) :
    Contact details
    Mobile
    919028299869 Email ID: [email protected]
    Number
    2.Legal Reservation Information
    Category Type :
    Category : GEN
    Open
    Is Guardian from EBC (Economic
    Is Specially Abled? No
    Backward Class)? No
    3.Social Information(Additional Inforamtion)
    Not Applicable
    Paper Selected for:
    Sem V
    MEC501 - Mechanical Measurements and Controls MEC502 - Thermal Engineering
    MEC503 - Dynamics of Machinery MEC504 - Finite Element Analysis
    MEL501 - Thermal Engineering MEL502 - Dynamics of Machinery
    MEL503 - Finite Element Analysis MEPBL501 - Mini Project – 2 A
    MESBL501 - Professional communication and ethics –II MEDLO5011 - Optimization Techniques
    Sem VI

    MEC601 - Machine Design MEC602 - Turbo Machinery


    MEC603 - Heating, Ventilation, Air conditioning and MEC604 - Automation and Artificial Intelligence
    Refrigeration MEL601 - Machine Design
    MEL603 - Heating, Ventilation, Air conditioning and MEL602 - Turbo Machinery
    Refrigeration MEPBL601 - Mini Project – 2 B
    MESBL601 - Measurements and Automation MEDLO6023 - Metal Forming Technology

    Medium of Instruction : English


    4.Guardian Information
    Occupation of Guardian : Business Annual Income of Guardian : 0
    5.Educational Details
    Month Exam
    Name of Name of Board/University Name of Certificate Mark Out
    and Year Seat CGPA %
    Examination and State of University School/College No. Obtained of
    of Passing No.
    MAHARASHTRA STATE
    BOARD OF SECONDARY March
    Std 10th -- -- 343.00 500.00 -- - -- 68.60
    AND HIGHER SECONDARY 2019
    EDUCATION,
    MAHARASHTRA STATE
    Std 12th 12Th BOARD OF SECONDARY August
    -- -- 495.00 600.00 -- - -- 82.50
    (Science) AND HIGHER SECONDARY 2021
    EDUCATION,
    Your Last Qualifying Exam:
    7.Other Information
    Would you like to apply for Hostel accommodation required NA
    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 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 )
    Document printed on Thu Oct 17 2024 00:50:45 GMT+0530 (India Standard Time)

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