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03-May-2022
Interview Schedule : 01/6/21 at 900 am and 1200 pm
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Application Form
Personal Information Section:
Applicant Name:
First Name
*
Middle Name
Last Name
*
Father's Name:
First Name
*
Middle Name
Last Name
*
Mother's Name:
First Name
*
Middle Name
Last Name
*
Date of Birth
*
Place OF Birth
Religion
Sex
*
--Select Sex--
Male
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Blood Group with Rh
Citizan of Country Name
Perment Address
*
:
Tal.
District
Pin Code
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STD Code
Phone 1
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Phone 2
Mobile 1
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Email ID:
Other Email:
Legal Reservation Information Section :
Domicile of State:
Category
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:
---Select Category---
SC
ST
NT(A)
NT(B)
NT(C)
DT/VJ
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Caste:
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Education Details Section:
Name Of College
*
:
Grade / Total Marks obtained
*
:
Out OF
Grade / Total Marks MH/CET
*
:
Out OF
Date of Results:
Guardian Information Section:
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Occupation of the Guardian :
--Select Occupation--
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Profession
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Relationship of guardian with Applicant:
Phone No. with STD Code:
Annual Income Of the Guardians(Rs.)
(Last Financial Year):Rs.
Attached Documents and Certificates Section (Original & Xerox):
MH-CET / AIEEE 2012 Marksheet
SSC Marksheet
HSC Marksheet
XII Leaving Certificate
Caste Certificate
Caste Validity Certificate
Non Creamy Layer Certificate(Valid upto 31 March 2012)
Domicile / Nationality Certificate
Whether you want to stay in hostel:
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