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Application - Under Graduate - MHT-CET 2019
Application - Under Graduate - MHT-CET 2019
NOTE - The Candidate name should be filled as available on your SSC or equivalent and or HSC or equivalent Examination Marksheet or Board Certificate.
Father or Husband's Name/वड�ल �क�व� पत�च� न�व: Candidate's Last Name/उम�दव�र�च� आडन�व:
DILIP MANE
Date of Birth/जन्मत�र�ख:
07/06/2001
Are you an Indian National?/आपण ��रत�य आह�त क�?: Domicile Certificate of State/आप��कड� क�ण�� र�ज्य�च� अ�धव�स प्रम�णपत्र आह� ?: Category of Candidate/उम�दव�र�च� प्रवग�:
YES MAHARASHTRA OPEN
Do you possess Caste Certificate from Maharashtra?/आप��कड� मह�र��� �च� ज�त प्रम�णपत्र आह� क�?: Do you possess Caste Validity Certificate?/आप��कड� ज�त व�धत� प्रम�णपत्र आह� ?: Caste Validity Certificate No./ज�त व�धत� प्रम�णपत्र क्रम��क:
-- -- --
Caste Validity Receipt No./ज�त व�धत� अज� प�वत� क्रम��क: Do you possess Non Creamylayer Certificate (NCL)?/आप��कड� न�न-क्र�म� ल�यर च� प्रम�णपत्र आह� क�?: Non Creamylayer Certificate No./न�न क्र�म� ल�यर प्रम�णपत्र क्रम��क:
-- -- --
Non Creamylayer Receipt No./न�न क्र�म� ल�यर व�धत� अज� प�वत� क्रम��क: Non Creamylayer Certificate Valid Through Date/आपल� न�न-क्र��मल�यर प्रम�णपत्र क�ठ�� त�रख� पय�त व�ध Non Creamylayer Application Receipt Date/न�न-क्र�म�ल�यर अज� प�वत� त�र�ख:
-- आह� ?: --
-- Are you Person With Disability Candidate?/आपण �वकल��ग व्य�� आह�त क�?:
NO
Type of Disability/�वकल��गत�च� प्रक�र:
Do you Require Scribe/आप��ल� मदत�नस�च� आवश्यकत� आह� क�?: Do you Require ExtraTime/आप��ल� अ�धक व�ळ प��हज� आह� क�?:
-- --
J and K Migrant/ज�� क���र ��त�ल �थल��त�रत र�हव��� : Religion/धम�: Total Annual Family Income/उम�दव�र��� क�ट�� ��य��च� एक�ण व����क उत्पन्न:
NO HINDU 0 TO 2.5 LAKH
Have You Passed SSC / CBSE / ICSE / IB / IGCSE From India?/त��� दह�व�च� पर��� र�ज्य �� ट ��ड� / स���एसई / आयस�एसई /आय ��/आय ज� स� एस ई ��ड� मध�न ��रत�त�न उत�ण� ��ल� आह�त क�?:
YES
10th / SSC / CBSE / ICSE / IB / IGCSE Year of Passing/१० व�/ दह�व�च�/ स���एसई / आयस�एसई /आय 10th / SSC / CBSE / ICSE / IB / IGCSE Percentage Marks Obtained (Best of five)/१० व�/ दह�व�च�/ State where your 10th / SSC / CBSE / ICSE / IB / IGCSE School is situated/आपल� १० व�/
��/आय ज� स� एस ई च� उत्त�ण� व�� स���एसई / आयस�एसई /आय ��/आय ज� स� एस ई च� ट��व�र� (प�च सव�त्तम) दह�व�च� /स���एसई / आयस�एसई /आय ��/आय ज� स� एस ईच� ��ळ� क�ठ�� र�ज्य�त आह� ?
2016 86.40 MAHARASHTRA
District where your 10th / SSC / CBSE / ICSE / IB / IGCSE School is situated/आपल� १० व�/ Taluka where your 10th / SSC / CBSE / ICSE / IB / IGCSE School is situated/आपल� १० व�/ दह�व�च�/ 10th / SSC / CBSE / ICSE / IB / IGCSE School Name/आपल� १० व�/ दह�व�च�/ स���एसई / आयस�एसई /आय
दह�व�च� /स���एसई / आयस�एसई /आय ��/आय ज� स� एस ई च� ��ळ� क�ठ�� �ज���त आह� ? स���एसई / आयस�एसई /आय ��/आय ज� स� एस ई च� ��ळ� क�ठ�� त�ल���त आह� ? ��/आय ज� स� एस ईच� ��ळ� च� न�व
THANE THANE SHRIMATI SAVITRIDEVI THIRANI SCHOOL
Are you Appearing/Appeared 12th(HSC) Exam in 2019?/त��� २०१९ म�� ��र�व�च� पर��� द� त आह�त क�?: State where your 12th(HSC) College is situated/आपल� ��र�व�च� क�ल�ज क�ठ�� र�ज्य�त आह� ?: Year of Passing/उत्त�ण� व��:
NO MAHARASHTRA 2018
Mention the District/�ज���च� �नवड� कर�: Mention the Taluka/त�ल�क�च� �नवड� कर�: HSC School/College Name/��र�व��� ��ळ� च� / क�ल�जच� न�व:
THANE THANE RAMANANDA ARYA D A V COLLEGE
Preference 1/प्रथम प्र�ध�न्य: Preference 2/द� सर� प्र�ध�न्य: Preference 3/�तसर� प्र�ध�न्य:
ENGINNEERING AND TECHNOLOGY PHARMACY DAIRY TECHNOLOGY
I want to have the Question Paper in/मल� म��� प्रश्नप�त्रक� �� ����त हव� आह� :
ENGLISH
First Preference District/प्रथम �ज�� प्र�ध�न्य: Second Preference District/द� सर� �ज�� प्र�ध�न्य:
THANE MUMBAI CITY
Candidate's Account Details - Your Account Number will be used by State CET Cell/उम�दव�र��� ब�क ������ म���त� - ��ईट� ��ल��र� त�म�� अक�उ� ट ��बर�� व�पर क�ल� ��ईल
Name of the Account Holder/��क ख�त�ध�रक�च� न�व: Name of the Bank/��क�च� न�व: Name of the Branch/��क��� ��ख�च� न�व :
DILIP TUKARAM MANE ABHYUDAYA COOPRATIVE BANK LOKMANYA NAGAR
Type of Account/��क ख���च� प्रक�र: Bank Account Number/��क ख���च� क्रम��क: Bank's IFSC Code/��क�च� आयएफएसस� क�ड:
SAVING 041011100002254 ABHY0065041
I Agreed
I have gone through the information brochure and understood the eligibility and qualifying criteria.
The details entered in the above application are filled in by me and verified by me and true to the best of my knowledge and are binding on me.
I understand I will be liable for penal action for submitting incorrect information.
I am submitting the form. I will not be able to edit the application form once I submit it.