6/7/2018 ..:: State Common Entrance Test Cell, Government of Maharashtra ::..

First Year Degree in Engineering/Technology Admissions 2018 Application Form

STATE COMMON ENTRANCE TEST CELL, Maharashtra State

8th Floor, New Excelsior Building, A.K.Nayak Marg, Fort, Mumbai-400001. (M.S.)

Application Form for Admission to First Year of Under Graduate Technical Courses in Engineering and Technology for
the Academic Year 2018-19

Application ID : EN18113167 Version No : 1

Personal Details
Candidate's Full Name SAJAG
Father's Name NITIN SHARMA
Mother's Name DYUTI SHARMA
Gender Male
Date of Birth 15/09/2000
Candidature Type OMS
Home University Other Than Home University
Category Not Applicable
Category for Admission Not Applicable
Person with Disability Not Applicable
Defence Type Not Applicable
Applied for TFWS Seats No
Minority Candidature Type Not Applicable
Application Fee Paid ( ) 800/- Nationality India
I, the holder of Aadhaar Number [********2907], hereby give my consent to State CET Cell to obtain my
Aadhaar number for authentication with UIDAI. State CET Cell has informed me that my identity
Aadhaar Number
information would only be used for admission purpose and will be submitted to CIDR only for the purpose
of authentication.
Qualification Details
Qualification Marks Obtained Marks OutOf Percentage
SSC Mathematics Marks 76.00 100.00 76.00
SSC Science Marks 85.50 100.00 85.50
SSC English Marks 85.50 100.00 85.50
SSC Aggregate Marks 399.00 500.00 79.80
HSC Physics Marks 61.00 100.00 61.00
HSC Mathematics Marks 52.00 100.00 52.00
HSC Chemistry Marks 59.00 100.00 59.00
HSC English Marks 70.00 100.00 70.00
HSC Aggregate Marks 242.00 400.00 60.50
SSC Board Central Board of Secondary Education, Delhi
SSC Passing Year 2016 SSC Seat Number 6108649
Qualifying Exam HSC HSC Passing Status Passed
HSC Board Central Board of Secondary Education, Delhi
HSC Passing Year 2018 HSC Seat Number 6604885
MHT-CET 2018 Details
Appeared for CET Yes Roll No MM4251264
Physics Score 13 Chemistry Score 23
Mathematics Score 26 Total Score 62
JEE (Main) 2018 Paper-1 Details
Appeared for JEE Yes Roll No 27002460
Physics Score 15 Chemistry Score 23
Mathematics Score 16 Total Score 54
Note : Submit one set of application form along with documents mentioned below and get it verified & stamped at FC. The same
set of documents will be verified at the time of ARC verification.FC shall verify all documents and put FC stamp with date &
Signature on all copies of documents and return the same set of documents to the candidate along with Receipt-cum-
Acknowledgement of application form.
List of Documents Required at the time of Document Verification and Confirmation at Facilitation Center (Attach
Xerox Copies)
Sr. No. Document Name
1. Certificate of Indian Nationality in the Name of the Candidate.
2. Statement of Marks or Certificate of Passing SSC / Equivalent Examination.
3. Statement of Marks or Certificate of Passing HSC / Equivalent Examination.
4. Score Card of JEE Main (Paper - 1) 2018.
Declaration
I have read all the rules of admission and on understanding these Rules, I have filled this Application Form for Admission to First Year
of Under Graduate Technical Courses in Engineering and Technology for the Academic Year 2018-19. 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.
Place : Date : 07/06/2018
Printed On : 07/06/2018 10:26:21 AM
Last Modified On : 07/06/2018 3:23:40 PM Signature of Applicant
Last Modified By : EN18113167, 157.41.201.7:46622 (SAJAG)

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