8/31/23, 2:01 PM Directorate Of Technical Education, Maharashtra State, Mumbai

Helpline Numbers : 1800-123-7290 / 9873048895    (09.00 A.M to 07.00 P.M)

DIRECTORATE OF TECHNICAL EDUCATION, MAHARASHTRA STATE

3, Mahapalika Marg, Elphinstone Technical Highschool Campus, Mumbai - 400001.
Printable Application Form for Admission to First Year Post SSC Diploma Technical Courses in Engineering and
Technology for the year 2023-2024 (NON-CAP)
Application ID : DEN23262676 Version : 1 Mode Of Scrutiny : Physical-Scrutiny
Physical FC Details
Slot Date FC Code FC Details Slot Time Booked On

FC Name: Rajgad Dnyanpeeth's Technical Campus,Dhangwadi, Bhor

2023-08-31 FC6324 FC Address: S.No. 237, Dhangwadi, Tal. Bhor. Dist. Pune 3pm to 4pm 2023-08-31 13:37:23

FC Coordinator Name: Prof. Hemant B. Khandale

Personal Details
Full Name KOTHAWALE SIDDHESH RAMESH

Gender Male Date of Birth 04/08/2004

Category-Caste OPEN Religion Hindu
Mother Tongue Marathi Family Income ( ) 50,001 - 1,00,000
Nationality Indian Region Urban
Type of Candidature Maharashtra Candidature Type A
Person with Disability N.A.
Defence Type Not Applicable
Applied For TFWS No
Applied For EWS No
Minority Candidature Type-Religious/Linguistic Minority Not Applicable
District from which Candidate has Passed SSC Pune
Home District Pune
Qualification Details
Examination Marks Obtained Marks Out of Percentage
10th/S.S.C. Mathematics 54 100 54.00
10th/S.S.C. Science 66 100 66.00

10th/S.S.C. English 53 100 53.00

10th/S.S.C. Aggregate 284 500 56.80

SSC Others Details
SSC Board Maharashtra State Board of Secondary and Higher Secondary Education, Pune
SSC Status Passed SSC Passing Year 2021
SSC Seat No. C087275 SSC Technical NO
HSC Passed With MCVC ITI NO
Intermediate Grade (Drawing) NO
Payment Details
Payment Date : 31-08-2023 Total Amount( ) : 400 /-

Bank Reference ID: order_MWbtG64BvouITD Payment ID: pay_MWbtUKSLLbYP5c Transaction Amount: 400 /-
List of Required Documents to be Submited at the time of admission in the institute
Sr. No. Document Name
1 Statement of Marks or Certificate of Passing SSC / Equivalent Examination.
2 Statement of marks obtained at 12th/HSC.
3 Latest School Leaving Certificate
4 The School Leaving Certificate indicating the Nationality of the Candidate as 'Indian' Or The Place Of Birth In India.

Note : As per your selection of scrutiny mode[Physical Scrutiny Mode] - Please go to the nearest designated FC along with original copies of
above mentioned document for verification and confirmation of Application Form.
Declaration:  I have read all the rules of admission and on understanding these Rules, I have filled this Application Form for consideration of submission of Application Form at FC for the admission to First Year Post SSC
Diploma Technical Courses in Engineering and Technology Admissions for the academic Year 2023 - 2024. The information given by me in this application is true to the best of my knowledge & belief. If at later stage, it is
found that I have furnished wrong information and/or submitted false certificate(s), I am aware that my admission stands cancelled and fees paid by me will be forfeited. Further I will be subject to legal and/or penal action as
per the provisions of the law.
Signature of the Candidate
Date : 31-08-2023 Place :   (KOTHAWALE SIDDHESH RAMESH)
Last modified by : DEN23262676 Printed By : DEN23262676
Last modified on : 31-08-2023 02:00:25 PM Printed On : 31-08-2023 02:01:03 PM

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