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    Asma Bade
    This document is an application form for a B.Ed course. It contains personal information about the applicant such as name, date of birth, address, contact details, educational qualifications, and declaration. The applicant is providing details of their 10th, 12th, undergraduate degree and is applying for the B.Ed course at Prabhakar Patil Education Societys B.ED College affiliated with the University of Mumbai. The form collects information to process the application and ensure the applicant meets the eligibility criteria.

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    Online Form

    Uploaded by

    Asma Bade
    66 views2 pages
    This document is an application form for a B.Ed course. It contains personal information about the applicant such as name, date of birth, address, contact details, educational qualifications, and declaration. The applicant is providing details of their 10th, 12th, undergraduate degree and is applying for the B.Ed course at Prabhakar Patil Education Societys B.ED College affiliated with the University of Mumbai. The form collects information to process the application and ensure the applicant meets the eligibility criteria.

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    This document is an application form for a B.Ed course. It contains personal information about the applicant such as name, date of birth, address, contact details, educational qualifications, and declaration. The applicant is providing details of their 10th, 12th, undergraduate degree and is applying for the B.Ed course at Prabhakar Patil Education Societys B.ED College affiliated with the University of Mumbai. The form collects information to process the application and ensure the applicant meets the eligibility criteria.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    66 views2 pages

    Online Form

    Uploaded by

    Asma Bade
    This document is an application form for a B.Ed course. It contains personal information about the applicant such as name, date of birth, address, contact details, educational qualifications, and declaration. The applicant is providing details of their 10th, 12th, undergraduate degree and is applying for the B.Ed course at Prabhakar Patil Education Societys B.ED College affiliated with the University of Mumbai. The form collects information to process the application and ensure the applicant meets the eligibility criteria.

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    Download as pdf or txt
    of 2

    For Office Use

    Batch: Scrutiny Payment: Online/DD PI

    Only Serial:

    Prabhakar Patil Education Societys B.ED College (849)


    Near Gokuleshwar mandir in front of veshvi Ailbag Veshvi Alibag
    Application No :
    University of Mumbai 3729167
    M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
    Academic Year: 2020-2021 Regular
    APPLICATION FORM

    Course Applied for : B.Ed.(with Credits) - Regular - Rev16 - F.Y. B.Ed. Sem I [4E00141] (-) PRN:2018016402589593
    Application Date : 12/02/2021 Payment Category :

    1.Personal Information

    Candidate's Name(Regional) :
    Candidate's Name as printed on Mark BADE ASMA YUSUF
    sheet : [*This name will appear on all University records/documents]
    Father's/Husband's Name : YUSUF BADE Mother's Name : KHURSHID

    Marital Status : UnMarried Mother Tongue :


    Place Of Birth : MORBA Gender : Female Date of Birth (DD/MM/YYYY) : 04/07/1989
    Blood Group : Religion : Country of Citizenship : India
    Height : Not Available Weight : Not Available Hemoglobin : Not Available
    Is Student NRI/ Foreign National : No Domicile State: Maharashtra
    Address For Correspondence :
    Location Area : Not
    State : Maharashtra District : Mumbai City Tehsil : Mumbai City/Town/Village :
    Available
    Address (House 60, FLOOR-3, PLOT-2, HABIB APARTMENT, NAMDEO UMAJI BHALINGE MARK,
    Pin Code : 400067
    no,street/area/suburb etc.) : SANTA GADGE MAHARAJA MANDAI, BYCUL
    Contact details
    Mobile Number 919767940300 Email ID: [email protected]
    2.Legal Reservation Information
    Category Type : Open Category : GEN
    Is Specially Abled? No
    3.Social Information(Additional Inforamtion)

    Paper Selected for:


    Sem I [4E00141]
    75101 - Childhood And Growing Up 75102 - Knowledge and Curriculum
    75103 - Gender, School and Society UBEDSI.1.4 - Critical Understanding of ICT
    UBEDSI.1.5 - Project Based Course 1
    Sem II [4E00142]

    47612 - Learning And Teaching 47613 - Educational Management


    UBEDSII.2.2 - Pedagogy of School Subject I 47607 - Pedagogy of Teaching:Mathematics

    Medium of Instruction : English


    4.Guardian Information
    Occupation of Guardian : Professional Annual Income of Guardian : 50000
    5.Educational Details
    Month Exam
    Name of Board/University and Name of Certificate Mark
    Name of Examination and Year Seat Out of CGPA %
    State of University School/College No. Obtained
    of Passing No.
    MAHARASHTRA STATE
    BOARD OF SECONDARY AND March
    Std 10th -- -- 625.00 750.00 -- - -- 83.33
    HIGHER SECONDARY 2004
    EDUCATION,
    MAHARASHTRA STATE
    Std 12th 12Th BOARD OF SECONDARY AND February
    -- -- 438.00 600.00 -- - -- 73.00
    (Science) HIGHER SECONDARY 2006
    EDUCATION,
    Month Exam
    Name of Board/University and Name of Certificate Mark
    Name of Examination and Year Seat Out of CGPA %
    State of University School/College No. Obtained
    of Passing No.
    Degree : BSC
    COPUTER October
    -- -- 429.00 800.00 -- - -- 53.63
    SCIENCE(Bachelors) 2010
    Degree
    Degree : B.Sc.(With
    Credits)-Regular- Passed -- -- - - -- - -- -
    Rev16
    SIDDHARTH
    Degree : Bsc(Maths) University of COLLEGE OF ART
    April 2019 3000047 6th 518.00 800.00 -- - -- 64.75
    (Mathematics) Mumbai,Maharashtra SCIENCE
    COMMERCE
    Your Last Qualifying Exam: Bsc(Maths)
    7.Other Information
    Would you like to apply for Hostel accommodation required NA
    Required Documents and Certificates Section:
    Passing Certificate of Std 12th / Statement of Marks of Std 12th OR Original Passing Certificate /Statement of Marks of Last Qualifying Exam like
    degree,diploma,etc.

    Passing Certificate of Std 10th.

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

    Mark/Grade Statement of Semester-V

    Mark/Grade Statement of Semester-VI

    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 :3729167 (BADE ASMA YUSUF) 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 )
    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
    Document printed on Wed Feb 17 2021 20:01:45 GMT+0530 (India Standard Time)

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