Receipt-cum-Acknowledgement of Option Form for CAP Round - I for Admission to First Year of Under Graduate

Technical Courses in Engineering and Technology for the Academic Year 2017-18
Application ID : EN17159890 Version No : 2
Personal Details
Candidate's Name ANSARI SAMEER AHMED RAEES AHMED
Father's Name RAEES AHMED
Mother's Name FARHAT JAHAN
Gender Male
Date of Birth 29/07/1998
Candidature Type Maharashtra - Type A
Home University Mumbai University
Category Open
Category for Admission Open
Person with Disability Not Applicable
Defence Type Not Applicable
Applied for TFWS No
Minority Candidature Type No
Options Given By Candidate
Preference Preference Preference Preference
Choice Code Choice Code Choice Code Choice Code
Number Number Number Number
1 303650710 5 301224610 9 318524520 13 319924610
2 301224510 6 321524610 10 319924510 14 318224510
3 321524510 7 318124510 11 318124610 15 313924510
4 600624510 8 318524510 12 318524610
Declaration
I have read all the rules of admission and on understanding these Rules, I have lled this Option Form for consideration for CAP Round - I for Admission
to First Year of Under Graduate Technical Courses in Engineering and Technology for the Academic Year 2017-18. The information given by me in this Option Form is
true to the best of my knowledge & belief. If at later stage, it is found that I have furnished wrong information and/or submitted false certicate(s), I am aware that my
admission stands cancelled and fees paid by me will be forfeited. Further I will be subject to legal and/or penal action as per the provisions of the law.
Printed On : 26/06/2017 1:50:49 PM
Last Modied On : 26/06/2017 1:45:48 PM Signature of Candidate
Last Modied By : EN17159890, 49.33.150.194 (ANSARI SAMEER AHMED RAEES AHMED)
For Ofce Use Only
The Option Form for CAP Round - I for Admission to First Year of Under Graduate Technical Courses in Engineering and Technology for the Academic Year
2017-18 is conrmed as per the choices given above. We hereby acknowledge the conrmed Option Form.
Conrmed On : 26/06/2017 1:45:48 PM Commissioner & Competent Authority
Conrmed By : EN17159890, 49.33.150.194 State CET Cell, Maharashtra State, Mumbai