SANT GADGE BABA AMRAVATI UNIVERSITY
ENROLLMENT APPLICATION FORM
WINTER 2024
Type of Programme UG
Name of Course / Level Bachelors Degree in (B.E.(First Year))
Branch (B.E First Year)
Name of Dr. Sau Kamalatai Gawai Institute of Engineering and
College/Institute Technology, Darapur-(198)
College Area Rural
PRN
PERSONAL DETAILS
1. Full Name Of The Applicant: VAISHNAVI NANDKUMAR KOKATE /
2. Mother's Name: SAVITA
3. Gaurdian's/Husband's Full Name: MR. NANDKUMAR DAMODAR KOKATE
4. Correspondence Address: Nandkishor D.Kokate,Near Gajanan Maharaj Mandir,Mundgaon
,444001
5. Permanent Address: Nandkishor D.Kokate,Near Gajanan Maharaj Mandir,Mundgaon
,444001
6. E-mail-ID : [email protected]
7. Contact No. : 7387948050
8. Alternate Mobile No. :
9. Date of Birth: 13/2/2006
10. Applicant Gender: FEMALE
11.Category: OBC
12.Medium of Instruction: English
13.Differently Abled/Divyang: NO
14.Nationality: Indian
15.Enrollment No (If Already Enrolled) : NO
16.Name of Last Institute :
17.Information Regarding Qualifying Examination:
Name of the Name of Year of Roll
Percentage/CGPASubject Offered.
Exam Board/University Passing Number
Maharashtra
State Board of
H.S.S.C / Secondary and
Equivalent Higher 2024 V006375 43.17 Marathi,English,Maths,Physic,chemistry,Biology
Examination Secondary
Education,
Pune
To,
Director,
Board of Examinations and Evaluation.
S.G.B.A. University, Amravati,
Amravati-444 602.
Through :- Principal : ( Dr. Sau Kamalatai Gawai Institute of Engineering and Technology, Darapur-
(198) )
Sir,
I request you to enroll me as a student of your University. So far I have not been enrolled as a collegiate
student of Sant Gadge Baba Amravati University. I declare that I have not taken admission to any other
course in any other college nor submitted the enrolment application form and also not admitted/ not appearing
for any other examination of the University as an external candidate/Ex-Student. The necessary information
relating to me , is completely furnished in part A
Date of admission in college(mm/dd/yyyy) : 12/24/2024
Name of the course for which enrolment is sought. : B.E.(First Year)
Subjects offered:
SUBJECT CODE SUBJECT NAME
1AL100BS Applied Mathematics -I (BSC)
1AL101BS Engineering Physics (BSC)
1AL102ES Computer Programming (ESC)
1AL103ES Engineering Mechanics (ESC)
1AL104BS Engineering Physics (BSC) Lab
1AL105ES Computer Programming (ESC) Lab
1AL106ES Engineering Mechanics (ESC) Lab
1AL107ES Workshop (ESC) Lab
1AL109AE Professional Communication (ACE)
1AL110CC Co-curricular Course (CC)
1AL108VS2 (ME) Design Thinking & Idea Lab.
( Student should take printout of two copies & one copy Submit to College/Institute )
List of Documents
(Check List of Documents : [ tick (✔) or ( x )])
Non
Mark Leaving/Transfer Caste Caste Equivalence Migration Fees
Creamy
Sheet Certificate Validity Certificate Certificate Certificate Paid
Layer
Student ✔ ✔ ✔ ✔ ✔
I solemnly affirm that the information given above is correct in all respect, and have not got enrolled my name
in any other university or in college. I have offered only the medium & the subject which are permitted to the
college by the University. Further , I have taken admission in College / Department with an undertaking as
required U/S 127 (7) & (8) of Maharashtra Public University Act, 2016.
Applicant's Signature
