7/15/2021 ..:: State Common Entrance Test Cell, Government of Maharashtra ::..

Online Registration For MHT-CET 2021 Application Form

GOVERNMENT OF MAHARASHTRA
STATE COMMON ENTRANCE TEST CELL, MAHARASHTRA STATE

8th Floor, New Excelsior Building, A.K.Nayak Marg, Fort, Mumbai-400001. (M.S.)

Application Form for Online Registration For MHT-CET 2021

Application No. : 212191093

  
Version No : 1
Personal Details
Candidate's Full Name CHAVAN ONKAR ASHOKRAO

Father's Name ASHOKRAO

Mother's Name SINDHUTAI

Gender Male

Date of Birth 15/08/1996

Religion Hindu

Region Rural

Mother Tongue Marathi

Annual Family Income 15,001 - 50,000

Nationality Indian

MHT-CET Application Fee Paid (Rs . ) 800/-  

Permanent Address
Address Line 1 Dronagiri Nagar
Address Line 2 Near Hanuman Mandir,Hadgaon
Address Line 3 --
State Maharashtra District Nanded
Taluka Hadgaon Village Hadgaon (Rural)
PIN Code 431712
Address for Correspondence
Address Line 1 Dronagiri Nagar
Address Line 2 Near Hanuman Mandir,Hadgaon
Address Line 3 --
State Maharashtra District Nanded
Taluka Hadgaon Village Hadgaon (Rural)
PIN Code 431712
Telephone No -
Domicile and Category Details
Do You Belong to State of Maharashtra? Yes
Category Open
Wish to Apply for EWS (Economically Weaker Section) Seats ? No
Caste Name Maratha
Are you Person With Disability ? No
Qualification Details
SSC / Equivalent Details
Have you passed SSC or Equivalent Exam from India? Yes
Maharashtra State Board of Secondary and Higher Secondary
SSC/Equivalent Board
Education, Pune
SSC/Equivalent Passing Year 2012
SSC/Equivalent Percentage 68.00
State From Which you Passed SSC/Equivalent Maharashtra
District From Which you Passed SSC/Equivalent Nanded
Taluka From Which you Passed SSC/Equivalent Hadgaon
School Name of SSC/Equivalent VIVEKANAND MADHYAMIK VIDYALAYA, HADGAON
HSC / Equivalent Details
Are you Appearing /Appeared 12th (HSC) exam in 2021 Yes
HSC/Equivalent Board Andhra Pradesh Board of Intermediate Education, Hyderabad
HSC Passing Year NA
State Where your 12th(HSC)College is Situated Telangana
District Where your 12th(HSC)College is Situated Hyderabad

https://mhtcet2021.mahacet.org/CandidateModule/frmPrintApplicationForm 1/2
7/15/2021 ..:: State Common Entrance Test Cell, Government of Maharashtra ::..
Taluka Where your 12th(HSC)College is Situated Not Applicable
HSC School/College Name SRI.CHAITANYA JUNIOR COLLEGE, HYDRABAD
MHT-CET Examination Details
Subject Group for MHT-CET PCM (Physics, Chemistry and Mathematics)
Language for the Question Paper English
State for MHT-CET 2021 Examination Center Maharashtra
Exam Center at Preference Number 1 Nanded
Exam Center at Preference Number 2 Yavatmal
Exam Center at Preference Number 3 Nagpur
Exam Center at Preference Number 4 Latur
Document Uploaded
Sr. No. Document Name
1. Aadhaar Card

Declaration
I agree to the following conditions

I have gone through the information brochure and understand the eligibility and qualifying criteria.

The information filled by me is true tothe best of my knowledge.

I understand I will be liable for penal action for submitting incorrect information.
Date : 15/07/2021

Last Modified By : 212191093, 106.193.243.204

Last Modified On : 15/07/2021 7:31:37 PM

Signature of Applicant

Printed On : 15/07/2021 7:31:50 PM (CHAVAN ONKAR ASHOKRAO)

https://mhtcet2021.mahacet.org/CandidateModule/frmPrintApplicationForm 2/2