S.No: College of Social Work, Nirmala Niketan, Mumbai BSW Application Form 2018-2019 Attach passport size photo A) Basic Details 1. Name of the Candidate First Name Middle Name Surname 2. Gender: Male Female Third Gender 3. Present Address with PIN code: 4. Permanent Address with PIN code: 5. Contact Mobile Number: 6. Alternate Contact Number: 7. Email Address: 8. Date of Birth: 9. Place of Birth/ Domicile: 10. Nationality: Indian / Foreign / Dual 11. Religion Hindu Muslim Zoroastrian Sikh Buddhist Christian Any other (please specific): 12. Christian, Denomination Roman Catholic Other Christian *If Roman Catholic, please attach valid baptism certificate 1 P a g e
13. Caste General SC ST OBC (Among Maharashtra Candidates only) SBC (Among Maharashtra Candidates only) NT DT *Please attach the respective caste certificates 14. Disability Status Yes No (If yes, please attach relevent certificates) 15. Marital Status Married Single B) Family Details 16. Name of the : Mother: 17. Educational Qualification Mother: 18. Parental Occupation Mother 19. Mobile Number & Email ID Mother Spouse 20. Have your parents served in the Indian Armed Forces in any capacity? Yes No (If yes, please attach relevent certificates) 21. Family Income: (Please Tick) Below Rs.50000 Rs. 50000 to Rs. 100000 Rs.100001 to 200000 Rs.200001 to 300000 Rs.300001 to 500000 Rs.500001 and above *Please submit income certificate if the income is below Rs 50,000 2 P a g e
Guardian s Details (compulsory for non- Mumbai applicants) 22. Name of the Guardian 23. Relationship 24. Address 25. Mobile / Telephone Number/s & E mail ID C) Educational Details 26. Exam Cleared CERTIFICATION Name of the Board Period (From. to.) No. of attempts Marks Obtained Out of Maximum Percentage Result Pending ( Yes/ No, If Yes, Please specify the reason ) 10 th (S.S.C) 12 th (H.S.C) * Please attach mark sheets and certificates ** If your statement of marks is in grades, please convert in percentage and attach grade converter of your Board) D) Mumbai University Requirements The University of Mumbai has made it mandatory for all candidates seeking admission to the First year courses in the Degree Colleges to fill in the Pre Admission Online Registration Form is available on mum.digitaluniversity.ac The Once you register in the website (link will open on 1 st June 2018), you will get a register number. Take a copy of the registration form. Fill the register number below: 27. Mumbai University Registration Number 3 P a g e
E) Application Fee/ DD Details 28. Name, Branch & Place of the Bank 29. DD Amount 30. DD Number 31. DD Date (Please attach DD) (Rs 500 for General candidates and Rs 400 for Roman Catholics and SC/ST/NT/DT/ OBC candidates). The fee should be paid in the form of a demand draft in favour of College of Social Work, payable at Mumbai, with the candidate s name, email, and phone number on the rear side of the DD. Please note that the DD has to be prepared from nationalised bank only. F) Declaration I, hereby declare that all the above information shared by me is true to the best of my knowledge and information. I affirm that I am personally responsible for any discrepancies in the data given by me, if any. In such event, the college can take appropriate action including cancellation of admission at any stage. Date of submission: Place: Signature of the applicant NOTE: The offer of admission will be notified on the website, and on the College Notice Board. Selected students should pay the fees in the given time frame (proposed by university through circular). On being admitted, the student shall immediately submit the following documents (Original along attested photocopies): H.S.C. Statement of Marks Baptism Certificate (for Minority Community - Christians) Caste Certificate (wherever applicable) Passing Certificate (required for getting Eligibility Certificate) Migration Certificate (required for getting Eligibility Certificate) 4 P a g e
Candidates passing Class XII Examinations from Foreign Boards and students passing from International Baccalaureate (I.B.) or A levels examinations - General Certificate of Education (GCE) / Cambridge International School Exam (CIE) of Cambridge or University of London are required to first approach the University of Mumbai, Eligibility Section, Kalina Campus, Santacruz (East), Mumbai 400 098 and obtain a PRIMA FACIE Eligibility Letter from the University of Mumbai for the purpose of admissions to BSW Programme. Students passing the Class XII from Boards / Universities other than Maharashtra State Board and seeking admissions to First Year BSW Programme are required to apply for a Provisional Eligibility Certificate through the College at the time of admission. ------------------------------------------------------------------------------------------------------------------------------- G) Checklist for Admission Clerk Please check if photocopies of the following certificates are attached before accepting the BSW Application form. a) Mumbai University Online Registration Form b) Demand Draft c) Baptism Certificate (for Roman Catholic Candidates) d) Caste certificate (if applicable) e) School leaving certificate f) Mark sheet of SSC g) Mark sheet of HSC h) Migration Certificate i) Disability certificate (if applicable) j) Ex-Serviceman Certificate (if applicable) Date : Check & verify by Name : 5 P a g e