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G O M S C E T C M S: Application No.: 231035219 Version No: 1

The document is an online application form for MHT-CET 2023 completed by Kenjale Komal Ananda, providing personal details like name, gender, birthdate, family income, address, educational qualifications, exam preferences, and a declaration agreeing to conditions and validity of information. The form includes details of the applicant's SSC and HSC education and marks, domicile and caste category information, subject group and language preferences for the entrance exam, and documents uploaded including an Aadhaar card.

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Omkar
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179 views

G O M S C E T C M S: Application No.: 231035219 Version No: 1

The document is an online application form for MHT-CET 2023 completed by Kenjale Komal Ananda, providing personal details like name, gender, birthdate, family income, address, educational qualifications, exam preferences, and a declaration agreeing to conditions and validity of information. The form includes details of the applicant's SSC and HSC education and marks, domicile and caste category information, subject group and language preferences for the entrance exam, and documents uploaded including an Aadhaar card.

Uploaded by

Omkar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Online Registration For MHT-CET-2023 Application Form

GOVERNMENT OF MAHARASHTRA
STATE COMMON ENTRANCE TEST CELL, MAHARASHTRA STATE
8th Floor, New Excelsior Building, A.K.Nayak Marg, Fort, Mumbai-400001. (M.S.)

Application Form for Online Registration For MHT-CET-2023

Application No. : 231035219    Version No : 1


Personal Details

Candidate's Full Name KENJALE KOMAL ANANDA

Father's Name ANANDA

Mother's Name VIJAYA

Gender Female

Date of Birth 29/03/2005

Religion Hindu

Region Rural

Mother Tongue Marathi

Annual Family Income 6,00,001 - 7,00,000

Nationality Indian

MHT-CET-2023 Application Fee Paid (Rs . ) 1200/-  


Permanent Address
Address Line 1 At malewadi post taradgaon
Address Line 2 Tal Phaltan
Address Line 3 Dist satara
State Maharashtra District Satara
Taluka Phaltan Village Malewadi
PIN Code 415528
Address for Correspondence
Address Line 1 At malewadi post taradgaon
Address Line 2 Tal Phaltan
Address Line 3 Dist satara
State Maharashtra District Satara
Taluka Phaltan Village Malewadi
PIN Code 415528
Telephone No -
Domicile and Category Details
Are you Domiciled in the State of Maharashtra? Yes
Category OBC
Do you possess Caste Certificate Available
Do you possess Caste Validity Not Applied
Do you Possess Non-Creamy Layer Available
Are you Person With Disability ? No
Qualification Details
SSC / Equivalent Details
Have you passed SSC or Equivalent Exam from India? Yes
SSC/Equivalent Board Maharashtra State Board of Secondary and Higher Secondary Education, Pune
SSC/Equivalent Passing Year 2021
SSC/Equivalent Percentage 81.80
State From Which you Passed SSC/Equivalent Maharashtra
District From Which you Passed SSC/Equivalent Satara
Taluka From Which you Passed SSC/Equivalent Phaltan
School Name of SSC/Equivalent SAHKAR MAHARSHI HANMANTRAO PAWAR HIGH SCHOOL PHALTAN
HSC / Equivalent Details
Are you Appearing /Appeared 12th (HSC) exam in 2023 Yes
HSC/Equivalent Board Maharashtra State Board of Secondary and Higher Secondary Education, Pune
HSC Passing Year NA
State Where your 12th(HSC)College is Situated Maharashtra
District Where your 12th(HSC)College is Situated Satara
Taluka Where your 12th(HSC)College is Situated Phaltan
HSC School/College Name MUDHOJI COLLEGE PHALTAN
MHT-CET-2023 Examination Details
Subject Group for MHT-CET-2023 Both(PCM and PCB) (Physics, Chemistry, Mathematics and Biology)
Language for the Question Paper English
State for MHT-CET-2023 Examination Center Maharashtra
Exam Center at Preference Number 1 Satara
Exam Center at Preference Number 2 Pune
Exam Center at Preference Number 3 Kolhapur
Exam Center at Preference Number 4 Mumbai City
Document Uploaded
Sr. No. Document Name
1. Aadhaar Card
Note :
• You are required to Upload the Caste Certificate clearly mentioning the Category of the Candidate and also the remarks that the Caste is recognised as backward class
in the State of Maharashtra at the time of Centralised Admission Process(CAP 2023).
• You are required to Upload the Caste / Tribe Validity Certificate in the name of the Candidate, issued by the caste validity committee of Maharashtra State at the time
of Centralised Admission Process(CAP 2023).
• You are required to Upload Non-Creamy Layer Certificate issued by Sub Divisional officer or Deputy Collector of the district in addition to the caste certificate valid
upto 31/03/2024 at the time of Centralised Admission Process(CAP 2023).
Declaration
I agree to the following conditions
I have gone through the information brochure and understand the eligibility and qualifying criteria.
The information filled by me is true to the best of my knowledge.
I understand I will be liable for penal action for submitting incorrect information.
Date : 12/03/2023

Last Modified By : 231035219, 152.57.213.66:59896

Last Modified On : 12/03/2023 10:00:59 AM


Signature of Applicant
Printed On : 12/03/2023 10:01:41 AM ( KENJALE KOMAL ANANDA )

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