First Year Deg ree in Eng ineering /Technolog y Admissions 2023-24 Application Form

GOVERNMENT OF MAHARASHT RA

STAT ECOMMONENT RANCET EST CELL,MAHARASHT RASTAT E

8th Floor, Ne w Exce ls ior Building , A.K.Naya k Ma rg , Fort, Mumba i-400001. (M.S .)

Application Form for Admission to First Year Under Graduate Technical Courses in
Eng ineering and Technolog y (4 Years) & Master of Eng ineering and Technolog y
(Integ rated 5 Years) Admissions A.Y. 2023-24
Application ID : EN23191844
  
Version No : 1
Booked Slot Date 02/07/2023 - 11:00AM - 12:00PM
(DD/MM/YYYY) and Time
SC1125 - Dwarka Bahu Uddeshiya Gramin Vikas Foundation, Rajarshi
SC Name and Address Shahu Colleg e of Eng ineering , Buldhana
Shahu Nag ar, Near Palna Ghar, Sag wan Road,
Buldhana-443001 (MH)
Personal Details
Candidate's Full Name BHOPALE SHRIJEET SATISH
Father's Name SATISH
Mother's Name MIRA
Gender Male
Date of Birth 06/07/2005
Candidature Type Maharashtra - Type A
Home University Sant Gadge Baba Amravati University
Category OBC

Category for
OBC
Admission
Applied for EWS No
Person with Disability Speech and Language Disability
Defence Type Not Applicable
Is Orphan Candidate No
Applied for TFWS
No
Seats
Minority Candidature
No
Type
District from which Candidate has Passed SSC Buldhana
District from which Candidate has Passed HSC / Diploma in
Buldhana
Engineering & Technology
Nationality India
MHT-CET Application Online Application Fee
600/- 0/-
Fee Paid (Rs.) Paid (Rs.)
Qualification Details:-BHOPALE SHRIJEET SATISH (Name As Per HSC Result)
Qualification Marks Obtained Marks OutOf Percentage
HSC Physics Marks 68.00 100.00 68.00
HSC Mathematics
60.00 100.00 60.00
Marks
HSC Chemistry Marks 69.00 100.00 69.00
 HSC Biology Marks 62.00 100.00 62.00
HSC English Marks 68.00 100.00 68.00
HSC Aggregate Marks 383.00 600.00 63.83
Maharashtra State Board of Secondary and Higher Secondary
SSC Board
Education, Pune
SSC Passing Year 2021 SSC Seat Number H089907
Qualifying Exam HSC HSC Passing Status Passed
Maharashtra State Board of Secondary and Higher Secondary
HSC Board
Education, Pune
HSC Passing Year 2023 HSC Seat Number V039618
MHT-CET 2023 Details:- BHOPALE SHRIJEET SATISH (Name As Per MHTCET Result)
Application Number 231034577 Roll No 2317179861
Physics 58.6681631 Chemistry 20.0187056
Mathematics 58.5484474 Total PCM 43.2248410
JEE (Main) 2023 Paper-1 NTA Score:-
Appeared for JEE No
List of Documents Required at the time of Document Verification and Confirmation at
Scrutiny Center
Sr. No. Document Name
1. Cert ificat e of Indian Nat ionalit y in t he Name of t he Candidat e.
2. Domicile Cert ificat e of t he Candidat e showing his / her Domicile St at e is Maharasht ra.
Cast e Cert ificat e clearly ment ioning t he Cat egory of t he Candidat e and also t he remarks
3.
t hat t he cast e is recognised as backward class in t he St at e of Maharasht ra.
Cast e / Tribe Validit y Cert ificat e in t he Name of t he Candidat e, issued by t he Cast e / Tribe
4.
Validit y Commit t ee of Maharasht ra St at e.
Non-Creamy Layer Cert ificat e issued by Sub Divisional officer or Deput y Collect or of t he
5.
Dist rict in addit ion t o t he Cast e Cert ificat e, valid upt o 31st March 2024.
Cert ificat e of Disabilit y from t he Direct or, All India Inst it ut e of Physically Handicapped,
6.
Mumbai or Dean / Civil Surgeon of t he Government / Civil Hospit als.
7. St at ement of Marks or Cert ificat e of Passing SSC / Equivalent Examinat ion.
St at ement of Marks or Cert ificat e of Passing HSC / Equivalent Examinat ion / Passing
8.
Marksheet /Cert ificat e of 3 years Diploma in Engineering and Technology.
9. Score Card of MHT-CET 2023.
Declaration

          
I have read all the rules of admission and Information brochure for admission to UG
courses 2023 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 2023-24. 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 forgery/Xerox copy 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 : 12/07/2023

Printed On : 12/07/2023 8:31:53 PM Signature of Applicant

Last Modified On : 27/06/2023 5:27:16 PM (BHOPALE SHRIJEET SATISH)

Last Modified By : EN23191844, 103.123.79.197:55690