212124, 10:19 PM State Common Entrance Test Cel, Government of Maharashtra [Online Registration For MAH-MCA-CET-2024 Application Form| GoveRNMENT OF MAHARASHTRA State Common ENTRANCE Test CELL, MAHARASHTRA STATE 8th Floor, New Excelsior Bullding, A.K.Nayak Marg, Fort, Mumbal-400003. (M.S.) Application No. : 244047558 Version No : 1 [Personal Details Mother's Name|MEERA Gender|Male arital Status|nMarried Spouse's Name Date of Birth|18708/2002 Religion|tindw Region|urban. ‘Mother Tongue[Marathi “Annual Family Income|50,003 - ,00,000 Nationality indian HAP MCR-CET- 2024 Applcaton Fee Pag (02000/- | [Permanent Address [Address for Correspondence Agress Line [ot post.yermals,tq-kafamb.dist-dharsshiv Adaress Line Ist post yermate,tarkafor dit-harastiv ‘Address Line 2[at post-yermale.tq-kalamb,dlat-dhareahiv ‘Address Line at post.yermala,tq-kalamb dit-dharashiv Asdress Line laharashiv Address Une 3[eharashiv State|Maharashira Diawieosmanabad State Maharashtra Daraaoamanabad Fin Cogelaia5a5 in Coselai3525 Telephone Nal: 7499100866 [Domicile and Category Details ‘Are you Dorilled in the State of Maharashira]ves. Catesorvlopen Belongs to Caste[brahman Wish to Apply for EWS (Economically Weaker Section) Seals Vee Tre you Person With Disabilty ?[No Belongs to Minority Category|Ne Religious Minortty|NA. ‘Orphan Details ‘ra you Orphan?[No [qualification Detail [SSC / Equivalent Details SSC/Equlval (Passing Year ozs 'SSC/Eguivalent Percentoge|60.00 'SSC/Equivalent Board Maharashtra State Board of Secondary and Higher Secondary Education, Pune Slate From WHE you Passed SSc/Equivalent/Maharashtre [MSG / Equivalent Details ‘re you Appearing Appear Tah (HSC) ram in 202Ne HSC Passing Year|2020) IMaharashtra State Board of Secondary and Higher Secondary [Edueation, Pune, ‘qualification Marks Obtained Marks Outor [Graduation / Equivalent Details HSC/Equivalent Board ‘Graduation Possing Year|2023 ‘Graduation Branch]@cs Duration of Graduation in Vears|3 Have you Studled/Appearing Mathematics as one of the subjects af {(o%2} level or be Graduate level examination |S ‘Graduation Marks Type[Pereentage ‘Qualification Marie Obtained Marks Outor Percentage: Awarded Class (Graduation 2229,00, "3000.00 74,30 First Class: nitpsiimeacet2024.mahacetorg/CandidateModuletrmPrntApplicationForm 12212124, 10:19 PM State Common Entrance Test MAH-MCA-CET-2024 Examination Detail Exam Center District at Preference Number 2[Aurangabad Exam Cer el, Government of Maharashtra District at Preference Number <|Nagpur lDocument Uploaded Sr. No. Document Name 1. [Radhaar Cara vou are required to Upload Eligibility Certificate for Economically Weaker Section a the time of Centralised Admission Process(CAP 2024), Declaration : |. KULKARNI TEJAS MUKUND have downloaded the Information Brochure of MAH-MCA-CET-2024 and have read all the rules for lappearing tne CET and’ on understanding these Rules, I have filed this Application Form for appearing to MAN-MCA-CET-2024 for the Academie jvear 2024-25. This Intormation given by me in this application le true to the best of my Knowleoge & belle, If at later stage, itis found tat | Jrave furnished wrong informatation ang/or submitted false certificate(s}, T am aware that my admission stands cancelled and fees paid by mel fle forfeited. Further I wil be subject to legal and/or penal action as per the provisions of the lay. [pate : 12/02/2024 = a= [ose woaied oy: 244047550, 103-246.147-66,172,70.407. 420000382 ZR [printed on = 12/02/2024 10:10:05 PM nitpsiimeacet2024.mahacetorg/CandidateModuletrmPrntApplicationForm 22