7/12/2019

STUDENT COPY

L.R.T. COMMERCE COLLEGE, AKOLA (1101A) Application No :

Akola
Academic Year: 2019-2020 231304
YCMOU Study Center Submission Slip Distance Education

Instruction:
Please submit copy of this submission slip with following list of document to Study Center for Recommendation of Program for Admission
and/or Recommendation of Scholarship.
Please note that application shall be considered for admission only after recommendation by study center
If recommendation by study center not completed before last date of admission your application will be automatically cancelled. Please note that
university will not refund the fees in case of rejection by study center for want of Eligibility.

Course Applied for : MBA (P79)(with Credits) - Distance Education - 2015 CGPA - S.Y. M.B.A. Semester III (P79) PRN:2018017000478344
Application Date : 12/07/2019 Payment Category : 22
Exam Center Name [Code] : - [-]
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed on School VISHAL RAVINDRA GHATOL
leaving/Passing Certificate : [*This name will appear on all University records/documents]
Father's/Husband's Name : RAVINDRA GHATOL Mother's Name : SHOBHA
Marital Status : UnMarried Mother Tongue :
Place Of Birth : WADEGAON Gender : Male Date of Birth (DD/MM/YYYY) : 02/08/1994
Blood Group : Religion : Country of Citizenship : India
Height : Not Available Weight : Not Available Hemoglobin : Not Available
Is Student NRI/ Foreign National : No Domicile State:
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Akola Tehsil : Balapur City/Town/Village :
Available
Address (House
AT POST WADEGAON TALUKA-BALAPUR DISTRICT-AKOLA Pin Code : 444502
no,street/area/suburb etc.) :
Contact details
Mobile Number 9665179093 Email ID: vishalghatol900@gmail.com
2.Legal Reservation Information
Category Type : Reserved Category : OBC
Is Specially Abled? No
3.Social Information(Additional Inforamtion)

Paper Selected for:

Semester III
MBA301 - Strategic Management MBA302 - International Business And International Trade
MKG301 - Marketing Research MKG302 - Advertising And Sales Promotion
MKG304 - Services Marketing
Semester IV

MBA401 - Business Laws MBA402 - Management Information System

P97PRJ - Project Work MKG401 - Consumer Behaviour
MKG402 - Sales And Distribution Management MKG403 - Retail Marketing
GEN203 - Value Education

Medium of Instruction : English

Admission Fee Payment Details Payment Status : Paid Transaction Date : 12/07/2019
Transaction Number :
Fee Category : Regular Fees Transaction Type : Online Payment
2313041562966064382
Admission Late Fee - 100 Admission Super Late Fee - 500
Adm Exam Fee - 4350 Tution Fee - 4000
Registration Fee - 100 Development Fund Fee - 4450
Other Fee - 200 Total : 13100
4.Guardian Information
Occupation of Guardian : Farmer Annual Income of Guardian : 25000
5.Educational Details

1/4
7/12/2019

Month and Exam

Name of Name of Board/University and State of Name of Certificate Mark
Year of Seat Out Of CGPA %
Examination University School/College No. Obtained
Passing No.
Certificate : July 2017 -- -- 5395.00 8150.00 -- - -- 66.20
MAHARASHTRA STATE BOARD OF
Std 12th 12th February
SECONDARY AND HIGHER SECONDARY -- -- 324.00 600.00 -- - -- 54.00
(Science) 2012
EDUCATION,
MAHARASHTRA STATE BOARD OF
Std 10th SECONDARY AND HIGHER SECONDARY March 2010 -- -- 332.00 550.00 -- - -- 60.36
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 )
For College/Institute/Study Center Use Only
Designation Remarks / Particulars / Recommendations Signature and Date
Admission Clerk
Admission
Committee
Accountant/Cashier Cash Received: Rs. Receipt No.: Date:
Registrar/Office
Superintendent
Document printed on Fri Jul 12 2019 21:24:14 GMT+0530 (India Standard Time)

2/4
7/12/2019
[STUDY CENTER COPY]

L.R.T. COMMERCE COLLEGE, AKOLA (1101A) Application No :

Akola
Academic Year: 2019-2020 231304
YCMOU Study Center Submission Slip Distance Education

Instruction:
Please submit copy of this submission slip with following list of document to Study Center for Recommendation of Program for Admission
and/or Recommendation of Scholarship.
Please note that application shall be considered for admission only after recommendation by study center
If recommendation by study center not completed before last date of admission your application will be automatically cancelled. Please note that
university will not refund the fees in case of rejection by study center for want of Eligibility.

Course Applied for : MBA (P79)(with Credits) - Distance Education - 2015 CGPA - S.Y. M.B.A. Semester III (P79) PRN:2018017000478344
Application Date : 12/07/2019 Payment Category : 22
Exam Center Name [Code] : - [-]
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed on School VISHAL RAVINDRA GHATOL
leaving/Passing Certificate : [*This name will appear on all University records/documents]
Father's/Husband's Name : RAVINDRA GHATOL Mother's Name : SHOBHA
Marital Status : UnMarried Mother Tongue :
Place Of Birth : WADEGAON Gender : Male Date of Birth (DD/MM/YYYY) : 02/08/1994
Blood Group : Religion : Country of Citizenship : India
Height : Not Available Weight : Not Available Hemoglobin : Not Available
Is Student NRI/ Foreign National : No Domicile State:
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Akola Tehsil : Balapur City/Town/Village :
Available
Address (House
AT POST WADEGAON TALUKA-BALAPUR DISTRICT-AKOLA Pin Code : 444502
no,street/area/suburb etc.) :
Contact details
Mobile Number 9665179093 Email ID: vishalghatol900@gmail.com
2.Legal Reservation Information
Category Type : Reserved Category : OBC
Is Specially Abled? No
3.Social Information(Additional Inforamtion)

Paper Selected for:

Semester III
MBA301 - Strategic Management MBA302 - International Business And International Trade
MKG301 - Marketing Research MKG302 - Advertising And Sales Promotion
MKG304 - Services Marketing
Semester IV

MBA401 - Business Laws MBA402 - Management Information System

P97PRJ - Project Work MKG401 - Consumer Behaviour
MKG402 - Sales And Distribution Management MKG403 - Retail Marketing
GEN203 - Value Education

Medium of Instruction : English

Admission Fee Payment Details Payment Status : Paid Transaction Date : 12/07/2019
Transaction Number :
Fee Category : Regular Fees Transaction Type : Online Payment
2313041562966064382
Admission Late Fee - 100 Admission Super Late Fee - 500
Adm Exam Fee - 4350 Tution Fee - 4000
Registration Fee - 100 Development Fund Fee - 4450
Other Fee - 200 Total : 13100
4.Guardian Information
Occupation of Guardian : Farmer Annual Income of Guardian : 25000
5.Educational Details

3/4
7/12/2019

Month and Exam

Name of Name of Board/University and State of Name of Certificate Mark
Year of Seat Out Of CGPA %
Examination University School/College No. Obtained
Passing No.
Certificate : July 2017 -- -- 5395.00 8150.00 -- - -- 66.20
MAHARASHTRA STATE BOARD OF
Std 12th 12th February
SECONDARY AND HIGHER SECONDARY -- -- 324.00 600.00 -- - -- 54.00
(Science) 2012
EDUCATION,
MAHARASHTRA STATE BOARD OF
Std 10th SECONDARY AND HIGHER SECONDARY March 2010 -- -- 332.00 550.00 -- - -- 60.36
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 )
For College/Institute/Study Center Use Only
Designation Remarks / Particulars / Recommendations Signature and Date
Admission Clerk
Admission
Committee
Accountant/Cashier Cash Received: Rs. Receipt No.: Date:
Registrar/Office
Superintendent
Document printed on Fri Jul 12 2019 21:24:14 GMT+0530 (India Standard Time)

4/4