Directorate of Vocational Education and Training,

Maharashtra State
PROVISIONAL APPLICATION FORM : ITI ADMISSION 2022

10TH STANDARD EXAM DETAILS

10TH STANDARD EXAM BOARD Maharashtra State Board of Secondary and Higher Secondary Education
DETAILS
SEAT/ROLL NUMBER J074723 YEAR OF EXAM 2013

MONTH OF EXAM March DATE OF BIRTH 21-Nov-1996

CANDIDATE PROFILE DETAILS

REGISTRATION NUMBER 202206A002498 FIRST NAME NIKHIL

LAST NAME/ SURNAME MOGRE FATHER/ HUSBAND NAME VIJAY

MOTHER NAME SUSHMA GENDER Male

DATE OF BIRTH 21-Nov-1996 NATIONALITY Indian

MOTHER TONGUE Marathi RELIGION Hindu

CASTE CATEGORY SC CASTE Mehatar

NON CREAMY LAYER NA PRIMARY MOBILE NUMBER 8237291522

SECONDARY MOBILE NUMBER 7559109966 E-MAIL ID NIKHILMOGRE317@GMAIL.COM

ANNUAL FAMILY INCOME (₹) 2,50,001 – 2,99,999

ADDRESS DETAILS
ADDRESS LINE 1 KHALASILINE MOHAN NAGAR BEHIND CENTRAL RAILWAY HOSPITAL

ADDRESS LINE 2 CONTROL CHAL NEAR DRM OFFICE

COUNTRY India STATE Maharashtra

DISTRICT Nagpur TALUKA Nagpur (Urban)

CITY/ VILLAGE Nagpur(Urban) PIN CODE 440001

PARENT/ GUARDIAN DETAILS

ORPHAN CANDIDATE NA

NAME OF ORPHANAGE NA

STATE NA DISTRICT NA TALUKA NA

PARTICULARS FATHER MOTHER

FIRST NAME VIJAY SUSHMA

LAST NAME/ SURNAME MOGRE MOGRE

OCCUPATION/ RETIRED GOVERNMENT OF INDIA EMPLOYEE NOT EMPLOYEED

STATE IN WHICH POSTED/ WORKING Maharashtra NA

DISTRICT IN WHICH POSTED/ WORKING Nagpur NA

TALUKA WHICH POSTED/ WORKING Nagpur (Urban) NA

ANNUAL INCOME 2,50,001 – 2,99,999 No income

DOMICILED STATE Maharashtra Maharashtra

DOMICILED DISTRICT Nagpur Nagpur

DOMICILED TALUKA Nagpur (Urban) Nagpur (Urban)

DEFENCE CATEGORY DETAILS

DO YOU BELONG TO DEFENCE CATEGORY NA

PROVISIONAL APPLICATION FORM : ITI ADMISSION 2022 Registration number: 202206A002498

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 DEFENCE CATEGORY NA

PERSON WITH DISABILITY CATEGORY DETAILS

DO YOU BELONG TO PERSON WITH DISABILITY CATEGORY NA DISABILITY PERCENTAGE NA%

PERSON WITH DISABILITY CATEGORY NA

OTHER DETAILS
INTERMEDIATE DRAWING PASSED NA

EXTRA CURRICULAR ACTIVITIES NA

SPORTS CATEGORY NA SPORTS PARTICIPATION LEVEL NA

CANDIDATE PASSED FROM GOVERNMENT APPROVED & NA BOLSTER NA BOLSTER SCHOOL NA

RECOGNISED BOLSTER SCHOOL FROM MAHARASHTRA SCHOOL TALUKA
DISTRICT

PREVIOUS ITI DETAILS

HAVE YOU APPEARED FOR ITI PREVIOUSLY NA

YEAR OF ADMISSION NA YEAR OF PASSING NA

NAME OF ITI NA

NAME OF TRADE NA

STANDARD 10th/ SSC DETAILS

SCHOOL LOCATION DETAILS

SCHOOL LOCATED IN Maharashtra

SCHOOL DISTRICT Nagpur SCHOOL TALUKA Nagpur (Urban)

SCHOOL CITY/ VILLAGE Nagpur(Urban) SCHOOL LOCATION CATEGORY Maharashtra

SUBJECT AND MARKS DETAILS

DO YOU BELONG TO NATIONAL OPEN SCHOOL NA DO YOU BELONG TO BLIND/ HANDICAP SCHOOL NA

ARE YOU 10th / SSC PASS Yes HAVE YOU TAKEN TECHNICAL SUBJECT AT 10th/ SSC NA

STANDARD 10TH / SSC MARKS DETAILS

Subject MARATHI/ HINDI/ ENGLISH/ SOCIAL SCIENCE MATHEMATICS SCIENCE TECHNICAL TOTAL
REGIONAL SANSKRIT OTHER (GEOGRAPHY & SUBJECT
LANGUAGE LANGUAGE LANGUAGE HISTORY)

OUT OFF 100 100 100 100 150 100 0 650

OBTAINED 43 67 53 64 52 77 0 356

TOTAL MARKS AT STANDARD 10TH/SSC COMPUTED IN PROPORTION TO 500 MARKS

OUT OF MARKS 500.00 OBTAINED MARKS 273.85

ADDITIONAL WEIGHTAGE
PASSING INTERMEDIATE DRAWING EXAMINATION NA

TECHNICAL SUBJECT AT 10TH /SSC NA

PARTICIPATION IN SPORTS NA

BOLSTER SCHOOL CANDIDATE NA

DEFENCE CATEGORY NA

TOTAL ADDITIONAL WEIGHTAGE NA

APPLICABLE ADDITIONAL WEIGHTAGE (MAXIMUM CEILING = 50 MARKS ) NA

TOTAL MARKS AND WEIGHTAGE 273.85

PROVISIONAL APPLICATION FORM : ITI ADMISSION 2022 Registration number: 202206A002498

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 TOTAL MARKS FOR ITI ADMISSION MERIT LIST
TOTAL PERCENTAGE 54.77
(MERIT LIST SHALL BE GENERATE ON BASIS OF TOTAL PERCENTAGE)

HIGHEST QUALIFICATION LEVEL HSC NAME OF DEGREE Science

8th STD DETAILS

Passing Year 0 Percentage 0

Obtained Marks 0 Out of Marks 0

CANDIDATE HOME DISTRICT

HOME DISTRICT SELECTED BY CANDIDATE CANDIDATE TYPE
Nagpur A

UNDERTAKING BY CANDIDATE
1. I have read all the rules of admission and on understanding these rules, I have filled this application.
2.  The information given by me in this application is true to the best of my knowledge and belief
3 I understand that the information provided by me shall freeze after the payment of Application Fees and I shall not be
able to edit, change, add to delete any information.
4.   At
a later stage, if it is found that I have furnished wrong information or submitted false certificate, I am aware that my
admission stands cancelled and fees paid by me will be fortified. I will be subject to legal and/ or penal action as per
provision of the law.

Signature of Candidate

FEE PAYMENT
Applicable Fee (Rs) 100.00 Caste Category SC

Payment Status PAID Payment Date 17/06/2022 10:01:40

Transaction ID 11393216

IMPORTANT INSTRUCTIONS TO CANDIDATE

1. Dear 202206A002498 NIKHIL MOGRE you have completed the Application Form for ITI Admission and paid the Application Form
Fees.
2. Candidate was not required to upload any documents during filling up application form.

3. After payment of application form fees, candidate has to visit nearest Government or Private ITI to confirm application form.
4. To confirm application, candidate has to provide all the original documents for verification of the information provided in the
Application Form. The List of all required documents is provided on the Home Page of Admission Portal under Download Section
and Information Brochure (Annexure-3).
5. Concern ITI shall verify the information and if require shall instruct the candidate to edit the information as per the documents
provided by the candidate. ITI shall return original documents to the candidate after verification and confirmation of application.
6. Candidate should not submit any original document to any ITI for application confirmation process, since candidate shall be required
to produce original document for admission confirmation at the allotted ITI.
7. Candidate is not required to pay any fees for Application Confirmation to any ITI.

8. Candidate should contact Helpline if ITI does not return original documents after application confirmation or demands any fees for
application confirmation.
9. If Candidate wants to change any information in the Application Form, then such change can be done by Login to the account after
Provision Merit List during the “Grievance Redressal Round”. No changes can be done in the Application Form thereafter.
10. Candidate must provide all the documents for verification of the information provided in the Application Form during Admission
Confirmation at the allotted ITI.
11. Candidate shall fill & submit only One Online Application form which shall be applicable for admission to any CTS Trade in all
Government and Private ITI for the Seats available through CAP and institute level seats at Private ITI.
12. Candidates Filling/ Submitting more than One Application will be treated as Duplicate Forms and shall be rejected without any
communication to the candidates and such candidates will be debarred from the CAP.
13 All Admission related Information and also information after Admission to ITI/ Examination, etc. shall be sent through SMS on
“PRIMARY MOBILE NUMBER ” and hence “PRIMARY MOBILE NUMBER ” should be active throughout Admission Process and
thereafter. Hence Permanent Mobile Number should be entered as “PRIMARY MOBILE NUMBER ”.

PROVISIONAL APPLICATION FORM : ITI ADMISSION 2022 Registration number: 202206A002498

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14. Candidates can submit Option Form (ITI wise and Trade wise Options and Preferences) for each Admission Rounds. Options Form for
First Admission Round shall be available after confirmation of Application Form. Kindly refer Admission Schedule for submitting
Round wise Option Form.
15. If any candidate does not fill up option form for the next Admission Round then the option form submitted (if submitted) for
previous round shall be considered for next admission rounds.
16. All the admissions in Government and Private ITI in the State are done through Centralized Online Admission Process. It is
mandatory to submit Online Application Form for admission against all seats available for Centralized Admission Process and
Institute Level Seats. It is mandatory to submit Online Application Form for all admission against Institute Level Seats at Private ITI
(Trade wise 20% Seats) and Vacant Seats available after 5th Round (Counselling Round) at Private ITI
17. Candidates, Parents and All Industrial Training Institute should note that any admission done other than through Centralized
Admission Process shall not be approved under any circumstances.
18. Candidate should not share their Admission Account Password with any one. Maintain complete confidentiality regarding Password

LIST OF DOCUMENTS REQUIRED DURING CONFIRMATION OF ADMISSION

1. Documents Mandatory for all Candidates:
1.1. Nationality Certificate as Aadhar Card/ School Leaving Certificate/ Indian Passport/ Birth Certificate.
1.2. Mark sheet of Secondary School Certificate (SSC) Examination.
1.3. Latest School/ College Leaving Certificate.
2. Documents required for candidates claiming reservation:
2.1. Schedule Caste (SC)/ Schedule Tribe (ST): Certificate issued by Executive Magistrate of Maharashtra State certifying that
the Candidate’s Caste is recognized as Schedule Caste/ Schedule Tribe in Maharashtra State.
2.2. Vimukta Jati/ Denotified Tribes (A) (VJ/DT (NT-A)/ Nomadic Tribes – B/ C/ D (NT - B, C, D)/ Special Backward Caste (SBC)/
Other Backward Caste (OBC):
2.2.1. Certificate issued by Executive Magistrate of Maharashtra State certifying that the Candidate’s Caste is recognized
as respective Backward Caste in Maharashtra State.
2.2.2. Non Creamy Layer Certificate issued by Sub Divisional Officer/ Deputy Collector/ Collector/ District Executive
Magistrate valid till 31st March 2023.
2.3. Socially and Economically Backward Category:
2.3.1. Certificate issued by Executive Magistrate of Maharashtra State.
2.3.2. Non Creamy Layer Certificate issued by Sub Divisional Officer/ Deputy Collector/ Collector/ District Executive
Magistrate valid till 31st March 2023.
2.4. Economically Weaker Section Open Category:
2.4.1. Eligibility Certificate for Economically Weaker Section issued by Executive Magistrate of Maharashtra State.
2.4.2. Non Creamy Layer Certificate issued by Sub Divisional Officer/ Deputy Collector/ Collector/ District Executive
Magistrate valid till 31st March 2023.
3. Type – B Candidate: Domicile of Maharashtra State Certificate of the Candidate or Mother or Father.
4. Type – C Candidate: Certificate from the Head of the Organization mentioning that the Candidates Mother/ Father is an
employee of Govt. of Indian/ Govt. of India Undertaking mentioning the posting District in Maharashtra.
5. Type – D Candidate: Certificate from the Head of the Organization mentioning that the Candidates Mother/ Father is an
employee of Govt. of Maharashtra/ Govt. of Maharashtra Undertaking mentioning the posting District.
6. Ex-Serviceman:
6.1. Defence Service Certificate of the Candidate or his/ her Mother/ Father.
6.2. Domicile of Maharashtra State Certificate of the Candidate or Mother or Father.
7. Non Domicile of Maharashtra State Defence Service Employees:
7.1. Defence Service Certificate.
7.2. Certificate from the Head of the Organization mentioning that the Candidates Mother/ Father is in Defence Service
mentioning the posting District in Maharashtra.
7.3. Certificate from the Head of the Organization mentioning that the Candidates Mother/ Father are residing at the place of
previous posting mentioning the previous posting District in Maharashtra.
8. Person with Disability (PWD1/ PWD2/ PWD3/ PWD4/ PWD5): Certificate issued by Medical Board clearly mentioning the Type,
Percentage and Permanent Nature of Disability.
9. Minority Candidate:
9.1. Certificate as School Leaving Certificate or any other certificate mentioning the candidate belonging to Muslim, Buddhist,
Christian, Sikh, Parsi or Jain religion.
9.2. Domicile of Maharashtra State Certificate of the Candidate or Mother or Father.
10. Student with Technical Subject: Secondary School Certificate Mark sheet stating Technical Subject.
11. Documents required for Additional Mark Weightage:
11.1. Intermediate Drawing Examination: Intermediate Drawing Grade Examination Passing Certificate.
11.2. Sports: Certificate issued by Competent Authority.
11.3. Bolster School Candidate: Certificate issued by Competent Authority.
11.4. Candidate belonging to Orphanage: Certificate issued by Competent Authority.

PROVISIONAL APPLICATION FORM : ITI ADMISSION 2022 Registration number: 202206A002498

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