MAHATMA JYOTIBA PHULE RESEARCH AND TRAINING INSTITUTE (MAHAJYOTI), NAGPUR

Common Entrance Test (CET) for Various Coaching Schemes under MAHATMA JYOTIBA PHULE
RESEARCH AND TRAINING INSTITUTE (MAHAJYOTI), NAGPUR
180120

Registration Number : MA2024090003

Application Number : TEST2024090003

Full Name : Shivaraj Sampat Mane

Permission to sending notification/information : YES

regarding your selection process through
SMS/Email

Name of the Institute : MAHATMA JYOTIBA

PHULE RESEARCH AND
TRAINING INSTITUTE
(MAHAJYOTI), NAGPUR

Name of the Scheme: : Maharashtra Public

Service Commission
(MPSC) Non Gazettd
Group B And C
Competitive Exam Pre-
Training Scheme At
Maharahstra

Choose examination city 1 : KOLHAPUR

Choose examination city 2 : SANGLI

Choose examination city 3 : PUNE

Choose examination city 4 : MUMBAI

Choose examination city 5 : SATARA

Category : NT-C

Select Caste : DHANGAR

Are you an Orphan Child (अनाथ)? : NO

Orphan Type? : -

Do you have Caste Certificate? : YES

Caste Certificate Number? : MAG/SR/1342/2012

Do you have Non creamy layer certificate? : YES

Valid date of Non creamy layer certificate : 31-03-2025

Do you have Domicile Certificate of Maharashtra? : YES

Income Group : Non Creamy Layer

Are you a Person with Disabilities (दिव्यांग) ? : NO

Type of Disability : -

Percentage % of Disability : -

Are you Government Employee? : NO

Aadhar Card No. : 439910933792

 Nationality : Indian

Personal Details

Gender : MALE

Date of Birth : 07-08-2001

Age completed as on 01.08.2024 : 22 years, 11 months, 25

days
Marital Status : Unmarried

Father's Name : Sampat

Mother's Name : Sakhubai

Spouse's Name : -

Correspondence Address

Address 1 : At. Po. Kole Tal. Sangola

Dist. Solapur
State : Maharashtra

District : SOLAPUR

Taluka/ Block : SANGOLE

Pincode : 413314

Permanent address

Address 1 : At. Po. Kole Tal. Sangola

Dist. Solapur
State : Maharashtra

District : SOLAPUR

Taluka/ Block : SANGOLE

Pincode : 413314

Contact Details

Mobile No : +91 7448234323

Alternative Number : +91 9158583942

(Mobile No / Landline No)
Email ID : shivmane4101@gmail.com

Educational Qualification (as on 03.07.2024)

Exam Passed Stream Board/ University Passing Marks/Grade Maximum % of

Name Year Obtained Marks/Grade Marks
point

SSC / 10th Standard - STATE BOARD 08-06-2018 440.00 500.00 88.00

HSC / 12th Standard SCIENCE STATE BOARD 16-07-2020 464.00 650.00 71.38
/ Equivalent

Graduation or ARTS YCMOU Nashik 06-07-2023 777.00 1200.00 64.75

Equivalent

Uploaded Document Details :

1. Scanned Copy of Candidate 10th Marks Sheet/Certificate

2. Scanned Copy of Candidate Intermediate or 10+2 Marks Sheet/Certificate

3. Scanned Copy of Candidate Graduation Marks Sheet/Certificate

4. Residential Certificate/Domicile Certificate

5. Aadhar Card (Front/Back)

6. Caste Certificate

7. Non creamy layer (Given by Tahsildar)

Declaration:

I hereby declare that all the statements made in this application are True, Complete and Correct to the best of my
knowledge and belief. I understand that in the event of any information being found untrue or incorrect at any stage or I
am not satisfying any of the eligibility criteria stipulated, and also in case of creating influence/undue pressure
regarding selection process shall tantamount to cancellation of my candidature.

Date: 08-07-2024 Signature of Applicant