MTA(I) EACHERS' ASSOCIATION (INDIA) MATHEMATICS. Registration No. : MTA22514470 || MTA22514470 Personal Details First Name [Gaurav Middle Name [Sunatant [ast Name Phadate Father's / Mother's Father's / Mother's! ts uryakant Phadale I Name [Aadharcard Date of Birth [zaroa/2008 Id Number [515971617955 [Gender Mate Nationality ndianCitizen Mobile No. 769275105 [Email ia lgaryphadale@gmai.com [Aiternative 5 [Alternative Alternative roat2asa75 ene suryarphadale@gmail.com School Details School Type Private [Schoo Name [Pace Junior Science College Powai class rans ISchoot Address |AWing, First Floor, Supreme Business Park. behind Lake Castle Bulding, Powai [School Pincode [400076 lschoot District [Mumbai [School State Maharashtra Region Belong To _|Maharashira-Mumbai Board [STATEBOARD Medium ENGLISH Address Details Permanent Address ‘Address at the time of IOQM Examination Door No. | E:2002, Arkade Earth, KanjurMarg East E-2002, Arkade Earth, KanjurMarg East Street KanjurMarg East KanjurMarg East [Landmark [Near Lodha [Near Lodha City [Mumbai Mumbai District [Mumbai Mumbai State Maharashira Maharashira Pincode [400042 400042 Subject loam Language ENGLISH Center Preference Conter Namo lMHM0003 - pace junior science college andheri Center Preference 1 Center Preference 2 Center Proference 3 NIA NIA NIA Payment Details [Amount 200 [Transaction No 11000125823496 ‘Transaction Date | 17/09/2022 22:53:38 Status [Success Declaration Thereby dectare that the above statements are true and complete to the best of my knowledge and belief, In case of any changes in the information furnished above. the same will be informed forthwith. In the event. the information is found to be false or incorrect