PRAHLADRAI DALMIA LIONS COLLEGE OF COMMERCE &

ECONOMICS
Sunder Nagar, S. V. Raod, Malad (W) Mumbai - 400 064

For Office Use Only

REGISTRATION ID. : AP15-16/11674

MKCL No . : 848660

RECEIPT NO. :................ID NO. ..................... DATE : ...................... CONSESSION :...................

To,
The Principal
PRAHLADRAI DALMIA LIONS COLLEGE OF COMMERCE & ECONOMICS

0626

Form No

Applied to Course

: FY BAF

Personal Details
SURNAME

FIRST NAME

MIDDLE NAME

1.

Candidates Name

: SUTHAR

HEMRAJ

NARULAL

2.

Father's Name

: SUTHAR

NARULAL

KAJODIMAL

3.

Mother's Name

: PYARI

4.

Married / Unmarried

: MARRIED

5.

Male / Female

: MALE

6.

Foreign Student

: NO

7.

Mother Tounge

: MARWADI

8.

Local Address

: PLOT NO.16, GATE NO.5, ROOM NO.1156, BMC COLONY, MALWANI, MALAD
WEST.
HOUSE

NO

1156

AREA/LOCATION

BMC

COLONY

TALUKA

BORIVALI

BORIVALI

CITY/DISTRICT : MUMBAI-CITY STATE : MAHARASHTRA COUNTRY : INDIA

9.

Permanent Address

: PLOT NO.16, GATE NO.5, ROOM NO.1156, BMC COLONY, MALWANI, MALAD

WEST.
HOUSE

NO

1156

AREA/LOCATION

BMC

COLONY

TALUKA

CITY/DISTRICT : MUMBAI-CITY STATE : MAHARASHTRA COUNTRY : INDIA

10. Place of Birth

: MUMBAI

11. Date of Birth

: 19/03/1997

12. Category

13. Caste

: MARWARI

14. Religion

: HINDU

15. Minority

: NO

16. Phy. Handicapped

: NO

17. Last School/College

: KG MITTAL JUNIOR COLLEGE OF ARTS AND COMMERCE

OPEN

18. Social Reservation

: --

19. Identification Mark

: MOLE ON RIGHT CHEEK

20. Blood Group

: O +VE

21. Hobbies

: PLAYING CRICKET

22. Employed Status

: NO

23. Designation

24. Wish to join NCC/NSS

: NA

25. Sports Participation

: 0

26. In House/Outsider

: OUT

Contact Details:
1.

Mob. No.

: 9920871279

2.

Parents Ph. No.

3.

Email Id

: sutharhemraj@yahoo.com

Parents And Gardian Details

1.

Father's Occupation

BUSINESS

2.

Father's Orgnization

FANCY JWELLERY

3.

Father's Designation

OWNER

4.

Mother's Occupation

HOUSE WIFE

5.

Mother's Orgnization

HOME

6.

Mother's Designation

HOUSE WIFE

7.

Parent Anual Income

8.

Parent Email Address

sutharhemraj@yahoo.com

9.

Staying With

PARENT

10. Gardians Name

13. Relation with Applicant

14. Native Address

70,000.00

PLOT NO.16, GATE NO.5, ROOM NO.1156, BMC COLONY, MALWANI, MALAD
WEST, MUMBAI-400095.

Academic Details :
Qualifying Exam

Year in
which
pass

H.S.C.

02-2015

Gap In Education

College Attended

KG MITTAL JUNIOR
COLLEGE OF ARTS
AND COMMERCE

Board / University

MAHARASTRA
BOARD

Marks
Obtained
427

Total
Marks

Percentage

650

65.69

NO

Documents Submitted at time of Admission

1
2
3
4
5

MARK SHEET
PASSING CERTIFICATE
LEAVING CERTIFICATE / DOMICILE CERTIFICATE / BOARD CERTIFICATE
ADDRESS PROOF : RATION CAR/ELECTRICITY BILL/TELEPHONE BILL/AGREEMENT COPY ETC.
IDENTITY PROOF : PAN CARD/ VOTER ID/ AADHAR CARD/ DRIVING LICENSE ETC.

I hereby agree, if admitted, to abide by the rules and regulations at present in force, or that may
hereafter
the

be

college,

made
I

for

will

the

do

administration

nothing

either

of

the

inside

college

or

and

outside

the

undertake
college,

that
that

so

long

will

as

interfere

am

student

with

its

of

orderly

working, discipline and anti-ragging policy.

Passing

and

produced

at

marks
the

certificates
time

of

of

University

admission.

Degree

Transfer

Examination

Certificate

from

Board

the

Examination

previous

college

passed
/

must

School

be

leaving

certificate / final eligibility certificate of the Pune University, as the case may be must be produced at the
time

of

admission.

submitted

to

the

Otherwise,

college,

the

the

admission

admission

is

shall

liable

be
to

be

provisional.

If

cancelled.

if

Transfer
my

Eligibility

admission

is

Certificate

cancelled

as

is

not

per

the

rules and regulations of the college, I shall not have any grievance whatsoever.
I hereby undertake to attend minimum 75% of lectures in the college. I am aware that if I fail to do so,
my term will not be granted

Date :

O.S.

10/06/2015

Signature of the Applicant

Asst. Prof.

Principal