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    Form Djcse

    Uploaded by

    Kavya Gohil

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    © All Rights Reserved
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    Form Djcse

    Uploaded by

    Kavya Gohil
    5 views2 pages

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    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
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    5 views2 pages

    Form Djcse

    Uploaded by

    Kavya Gohil

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Shri Vile Parle Kelavani Mandal's

    Dwarkadas J. Sanghvi College of Engineering


    Autonomous College Affiliated to the University of Mumbai
    NAAC Accredited with "A" Grade (CGPA: 3.18)
    Vile Parle (West) , Mumbai 400056
    Tel. 42335000/01
    Application No. First Year B. Tech (Vacancy Form) : Academic Year : 2024 - 25
    600968519

    Category : Gujarati Minority (CAP Vacancy)


    Domicile State : Maharashtra State CET Cell Application ID No. (EN..) : 241027211
    Passed SSC Exam from Maharashtra State : Yes Passed HSC Exam from Maharashtra State :Yes
    Application Form (Digital Mumbai Univ.) : Type :A

    Personal Details :
    Salutation First Name Father's/Middle Name Last Name Mother's Name
    Mr KAVYA VISHAL GOHIL BHAVANA
    Gender : MALE Birth Date DD.MM.YYYY : 19-05-2007

    Place of Birth : MUMBAI Nationality :Indian

    Marital Status : Single Blood Group :A+

    Religion : Hindu Social Category : Scheduled Caste (SC)

    Caste : MOCHI Disablity : None

    Aadhar Card No.: 4750XXXX44 ABC .: 630719680479

    Local Address For Correspondence :


    Address Line 1 : 1201, SIMPLEX KHUSHAANGAN,SV ROAD, Address Line 2 : OPP IBP PETROL PUMP, MALAD WEST

    Address Line 3 : City : MUMBAI

    State :Maharashtra Country : India

    Pin Code : 400064 Nearest Railway Station : MALAD WEST

    Telephone No. : Mobile No : 7304845096

    E - mail ID :[email protected]

    Permanent Address :
    Address Line 1 : 1201, SIMPLEX KHUSHAANGAN,SV ROAD, Address Line 2 : OPP IBP PETROL PUMP, MALAD WEST

    State :Maharashtra City : MUMBAI

    Address Line 3 : Country : India

    Pin Code : 400064

    Page1 of 2 User ID : KAVYGOHIL 600968519


    Educational Details : Is there any break in Education : NO
    12th - Score 10th Maths Marks

    Maths Physics Chemistry BT/B/T/V Total PCM Total PMB 371


    Marks Obtained 55 38 46 60 139 153
    500
    Marks Out of 100 100 100 100 300 300

    Year of Marks Marks


    Exam Board Month Names of Institute Address of Institute
    Passing Obtained Out of
    Swami vivekanand international school and jr. KANDIVALI, PAREKH
    10th SSC 03 2022 371.00 500.00
    college NAGAR
    SHANTILAL MODI ROAD,
    12th HSC 02 2024 323.00 600.00 Prakash Vidyalaya and junior college
    KANDIVALI WEST

    MAHARASHTRA CET Year : 2024

    Mathematics Physics Chemistry Total


    Percentile Obtained 34.9580046 69.2542632 80.9408671 62.7216425

    Parents Details :
    Father's First Name :VISHAL Mother's First Name : BHAVANA

    Father's Middle Name :BACHUBHAI Mother's Middle Name: VISHAL

    Father's Last Name : GOHIL Mother's Last Name :GOHIL

    Father's Occupation : Business Mother's Occupation :Housewife

    Father's Mobile No : 9892844309 Mother's Mobile No :9967430955

    Father's E - Mail ID : [email protected] Mother's E - Mail ID :[email protected]

    Family Annual Income: 800000.00


    Father's Office Address : Mother's Office Address :
    Address Line 1 :72, MEHTA INDUSTRIES, Address Line 1 :

    Address Line 2 :LIBERTY GARDEN, ROAD 3 Address Line 2 :

    City : MUMBAI City :

    Country : India Country : India

    State : Maharashtra State : Maharashtra

    Pin Code : 400064 Pin Code :

    Telephone : 9892723406 Telephone :

    Declaration :I declare that the information given above is true and also understand and agree that the management's decision on matters will
    be final. I have gone through the instructions while filling the form and have understood and comply with the same.
    I am fully aware that it is pre-requisite and mandatory to apply to the Competent Authority to be eligible for admission.
    I shall abide by all the rules and regulations of institute from time to time.

    Page2 of 2 User ID : KAVYGOHIL 600968519

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