..:: State Common Entrance Test Cell, Government of Maharashtra ::.. https://bedcet2021.mahacet.

org/CandidateModule/frmPrintApplicationForm

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 of Registration for MAH-B.Ed.-CET 2021

Application No. : 217662421 Version No : 2
Personal Details
Candidate's Full Name KURMI RAME SH C HANDRA UME SH C HANDRA
Father's Name UME SH C HANDRA Mo ther's Name KUT URA DE VI
Gender Male Date o f B irth 04/01/2001
Religio n Hindu Regio n Urban
Mo ther To ngue Hindi Natio nality Indian
Regis tratio n Fee Paid (Rs . ) 800/-
Permanent Address
A ddres s Line 1 ROOM NUMBE R 10, SHANT I C HAWL
A ddres s Line 2 RAM RAHIM C OMPOUND, NE W SHANT I NAGAR
A ddres s Line 3 SAFE DPUL,SAKINAKA
S tate Maharashtra Dis trict Mumbai Suburban
Taluka Kurla V illage C handivali
PIN Co de 400072 Telepho ne No -
Correspondence Address
A ddres s Line 1 VILLAGE -SHIVAPAR
A ddres s Line 2 POST - C HANDRAHAR
A ddres s Line 3
S tate Uttar Pradesh Dis trict Sant Kabir Nagar
Taluka Not Applicable V illage Not Applicable
PIN Co de 272164
Candidature Type Details
Type o f Candidature OMS
Category Details
Person With Disability Details
Pers o n With Dis ability No
Eligibility Qualification Details
Eligibility Qualificatio n Graduation
Qualification Details
Qualification Specialization Board / University Percentage Class Passing Month-Year
Maharashtra State Board of Secondary and
SSC -- 75.20 Distinction March-2015
Higher Secondary Education, Pune
Maharashtra State Board of Secondary and Second
HSC Science 56.15 February-2017
Higher Secondary Education, Pune Division
Graduation B.Sc. (Mathematics, Prof Rajendra Singh Rajju Bhaiya University First
64.00 March-2020
(B.Sc.) Physics) formerly Allahabad State University Division
MAH-B.Ed.-CET 2021 Examination Details
Want to A ppear fo r Englis h Language Co ntent Tes t (ELCT) to S eek
Yes
admis s io n in Englis h Medium Co lleges o f Educatio n
Want to A pply fo r S pecial Educatio n Co lleges No
Note :
1. The Candidate opting for Out of State centre should note that the centre chosen cannot be guaranteed.
2. Candidate to note centers given in the options may not be available if the Infrastructure is not available for conducting computer
based Test. In such case the candidate will be shifted to the centre of the next choice.
Ex aminatio n Center at Preference Number 1 Mumbai Suburban C entral
Ex aminatio n Center at Preference Number 2 T hane
Ex aminatio n Center at Preference Number 3 Mumbai Suburban Western
Document Uploaded
Sr. No. Document Name
1. PAN Card
Declaration
I undertake and declare that I have read the eligibility rules publis hed in the Info rmatio n B ro chure dis played o n the webs ite.
I hereby co nfirm that the info rmatio n provided by me is to the bes t o f my kno wledge true.
I am aware that the info rmatio n filled by the candidate in o nline cet A pplicatio n will no t be s crutiniz ed at any s tage o f CET.
Date : 27/07/2021
Las t Mo dified By : 217662421, 103.199.136.212
Las t Mo dified On : 27/07/2021 11:59:08 AM

1 of 2 27-07-2021, 11:59
..:: State Common Entrance Test Cell, Government of Maharashtra ::.. https://bedcet2021.mahacet.org/CandidateModule/frmPrintApplicationForm

S ignature o f A pplicant
Printed On : 27/07/2021 11:59:21 AM
(KURMI RAME SH C HANDRA UME SH C HANDRA)

2 of 2 27-07-2021, 11:59