8/12/2020
For Office Use
Batch: Scrutiny Payment: Online/DD PI
Only Serial:
Cosmopolitans Valia C.L. College of Commerce,B.Sc (IT),B.M.S. And Arts (37)
Application No :
University of Mumbai 2489442
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
Academic Year: 2020-2021
Regular
APPLICATION FORM
Course Applied for : B.M.M.(with Credits) - Regular - Rev16 - T.Y.B.M.M. Sem V [4O00155] (12300010) PRN:2018016401630901
Application Date : 12/08/2020 Payment Category : 28
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed on Mark DSOUZA NIXON GEORGE
sheet : [*This name will appear on all University records/documents]
Father's/Husband's Name : GEORGE DSOUZA Mother's Name : POONAM
Marital Status : UnMarried Mother Tongue :
Place Of Birth : MUMBAI Gender : Male Date of Birth (DD/MM/YYYY) : 02/02/2001
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 Suburban Tehsil : Andheri City/Town/Village :
Available
Address (House D BUILDING A WING 405 HRUSHIKESH APNA GHAR UNIT NO.1 , ANDHERI (W)
Pin Code : 400053
no,street/area/suburb etc.) : MUMBAI 400053
Contact details
Mobile Number 917715087887 Email ID: NIXON.DSOUZA40546@GMAIL.COM
2.Legal Reservation Information
Category Type : Open Category : GEN
Is Specially Abled? No
3.Social Information(Additional Inforamtion)
Paper Selected for:
Sem V [4O00155]
27301 - Advertising in Contemporary Society 27303 - Copy Writing
27306 - Brand Building 27307 - Consumer Behaviour
27309 - Media Planing and Buying UBMMA505 - Advertising Design (Practical Paper)
Sem VI [4O00156]
55601 - Advertising and Marketing Research 55603 - Legal Environment and Advertising Ethics
55605 - Financial Management for Marketing and Advertising 55607 - Agency Management
55609 - The Principles and Practice of Direct Marketing 55611 - Contemporary Issues
55613 - Degital Media
Medium of Instruction : English
4.Guardian Information
Occupation of Guardian : Business Annual Income of Guardian : 600000
5.Educational Details
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.
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8/12/2020
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.
Std 12th MAHARASHTRA STATE BOARD OF
12Th SECONDARY AND HIGHER SECONDARY May 2018 -- -- 482.00 650.00 -- - -- 74.15
(Science) 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 Wed Aug 12 2020 17:33:52 GMT+0530 (India Standard Time)
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