7/7/2021 ..:: State Common Entrance Test Cell, Government of Maharashtra ::..

Online Registration For MHT-CET 2021 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 2021

Application No. : 211935033 Version No : 1

Personal Details
Candidate's Full Name MRUNAL CHANDRASHEKHAR BAVISKAR

Father's Name CHANDRASHEKHAR

Mother's Name SANJIVANI

Gender Male

Date of Birth 07/02/2004

Religion Hindu

Region Urban

Mother Tongue Marathi

Annual Family Income 1,00,001 - 1,50,000

Nationality Indian

MHT-CET Application Fee Paid (Rs . ) 600/-

Permanent Address
Address Line 1 PLOT NO. 61
Address Line 2 PRABHAT NAGAR
Address Line 3 OPP. SATYA SAI CONVENT NARSALA ROAD
State Maharashtra District Nagpur
Taluka Nagpur (Urban) Village Nagpur (M Corp.)
PIN Code 440034
Address for Correspondence
Address Line 1 PLOT NO. 61
Address Line 2 PRABHAT NAGAR
Address Line 3 OPP. SATYA SAI CONVENT NARSALA ROAD
State Maharashtra District Nagpur
Taluka Nagpur (Urban) Village Nagpur (M Corp.)
PIN Code 440034
Telephone No -
Domicile and Category Details
Do You Belong to State of Maharashtra? Yes
Category OBC
Do you possess Caste Certificate Available
Do you possess Caste Validity Available
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
Maharashtra State Board of Secondary and Higher Secondary
SSC/Equivalent Board
Education, Pune
SSC/Equivalent Passing Year 2019
SSC/Equivalent Percentage 84.60
State From Which you Passed SSC/Equivalent Maharashtra
District From Which you Passed SSC/Equivalent Nagpur
Taluka From Which you Passed SSC/Equivalent Nagpur (Urban)
School Name of SSC/Equivalent SHREE.SATYA SAI CONVENT
HSC / Equivalent Details
Are you Appearing /Appeared 12th (HSC) exam in 2021 Yes
Maharashtra State Board of Secondary and Higher Secondary
HSC/Equivalent Board
Education, Pune
HSC Passing Year NA
State Where your 12th(HSC)College is Situated Maharashtra
District Where your 12th(HSC)College is Situated Nagpur
Taluka Where your 12th(HSC)College is Situated Nagpur (Urban)
HSC School/College Name MAJOR HEMANT JAKATE COLLEGE
MHT-CET Examination Details

https://mhtcet2021.mahacet.org/CandidateModule/frmPrintApplicationForm 1/2
7/7/2021 ..:: State Common Entrance Test Cell, Government of Maharashtra ::..
Subject Group for MHT-CET PCM (Physics, Chemistry and Mathematics)
Language for the Question Paper English
State for MHT-CET 2021 Examination Center Maharashtra
Exam Center at Preference Number 1 Nagpur
Exam Center at Preference Number 2 Amravati
Exam Center at Preference Number 3 Bhandara
Exam Center at Preference Number 4 Wardha
Document Uploaded
Sr. No. Document Name
1. Aadhaar Card
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 tothe best of my knowledge.
I understand I will be liable for penal action for submitting incorrect information.
Date : 08/07/2021

Last Modified By : 211935033, 106.195.13.253

Last Modified On : 08/07/2021 11:41:43 AM

Signature of Applicant
Printed On : 08/07/2021 11:42:05 AM (MRUNAL CHANDRASHEKHAR BAVISKAR)

https://mhtcet2021.mahacet.org/CandidateModule/frmPrintApplicationForm 2/2