2/25/22, 3:24 PM ..:: State Common Entrance Test Cell, Government of Maharashtra ::..

Online Registration For MHT-CET 2022 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 2022

Application No. : 221081012

  
Version No : 1
Personal Details
Candidate's Full Name DWIVEDI ANKUSH AJAY

Father's Name AJAY

Mother's Name SARITA

Gender Male

Date of Birth 02/03/2004

Religion Hindu

Region Urban

Mother Tongue Hindi

Annual Family Income -- Not Applicable --

Nationality Indian

MHT-CET Application Fee Paid (Rs . ) 800/-  

Permanent Address
Address Line 1 Ganga Housing Society
Address Line 2 Surendragadh, Seminary Hills
Address Line 3 Nagpur
State Maharashtra District Nagpur
Taluka Nagpur (Urban) Village Nagpur (M Corp.)
PIN Code 440006
Address for Correspondence
Address Line 1 Ganga Housing Society
Address Line 2 Surendragadh, Seminary Hills
Address Line 3 Nagpur
State Maharashtra District Nagpur
Taluka Nagpur (Urban) Village Nagpur (M Corp.)
PIN Code 440006
Telephone No -
Domicile and Category Details
Do You Belong to State of Maharashtra? Yes
Category Open
Wish to Apply for EWS (Economically Weaker Section) Seats ? No
Caste Name Brahmin
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 81.20
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 ST.JOHN'S HIGH SCHOOL
HSC / Equivalent Details
Are you Appearing /Appeared 12th (HSC) exam in 2022 No
Maharashtra State Board of Secondary and Higher Secondary
HSC/Equivalent Board
Education, Pune
HSC Passing Year 2021
State Where your 12th(HSC)College is Situated Maharashtra

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2/25/22, 3:24 PM ..:: State Common Entrance Test Cell, Government of Maharashtra ::..
District Where your 12th(HSC)College is Situated Nagpur
Taluka Where your 12th(HSC)College is Situated Nagpur (Urban)
HSC School/College Name SFS COLLEGE SEMINARY HILLS
MHT-CET Examination Details
Subject Group for MHT-CET PCM (Physics, Chemistry and Mathematics)
Language for the Question Paper English
State for MHT-CET 2022 Examination Center Maharashtra
Exam Center at Preference Number 1 Nagpur
Exam Center at Preference Number 2 Gadchiroli
Exam Center at Preference Number 3 Aurangabad
Exam Center at Preference Number 4 Chandrapur
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 to the best of my knowledge.

I understand I will be liable for penal action for submitting incorrect information.
Date : 25/02/2022

Last Modified By : 221081012, 152.57.172.210:52297

Last Modified On : 25/02/2022 3:23:01 PM

Signature of Applicant

Printed On : 25/02/2022 3:23:21 PM (DWIVEDI ANKUSH AJAY)

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