5121128, 1045 PM State Common Entrance Test Cel, Government of Maharashira [Online Registration For MHT-CET-2023 ‘Appl ation Form| g GoveERNMENT OF MAHARASHTRA State Common Entrance Test CeLt, MAHARASHTRA STATE ‘th Floor, New Excelsior Building, A.K.Nayak Marg, Fort, Mumbal-800003. (M.S.) ‘Application Form for Online Registration For MHT-CET=2023 Application No. : 231192623 Version No : 1 IPersonal Details ‘Candidate's Full Name|AMIT RANOAN YADAV Date of sith|16/05/2005 Relgion|winaw Region|Rural other Tongue|Hindi Nationatlyfindian MHT-CET-2089 Roplcation Fee Paid ()/8007= lPermanent Address Staie[URtar Pradesh Distr azamaarh TalukalNot Applicable Vilage|Not Applicable FIN Cone|276268 |Address for Correspondence StoielURar Pradesh Distr azamaarh TalukalNot Applicable Vilage|Not Applicable PIN code|276268 lephone Nol- ‘and Category Details ‘re you Damieed ih the State of Maharashta?(Ne [qualification Details ISSC / Equivalent Detail Hove you passed SSC or Fauivalent Fam from India? Vee 'SSC/Equivelent Goard|Central Board of Secondary Education, Delht ‘Se TEauivalent Passing Vear[z020 Distt From Whieh you Passed SSC/Equlvatent|Azamgarh ‘School Name of SSC/Fquivalent|ASHRAFIA CONVENT SCHOOL IHSC-7 Equivalent Details ‘re you Appearing /Appanred ith (HSC) exam in 202a|vew ¥iSC/Eaulvalent Board [Central Board of Secondary Education, Delhi HSC Passing Vear|WA Slate Where your TAA(HSC)College is situated|uttar Diatiet Where your 120% 1SC)College Ts Situated) Amb “Talus Where your 120H(HSC)Colege is Skusteg|Not Applicable HSC School/Collage Name|RADIANT CENTRAL ACADEMY JALALPUR AMBEDKAR NAGAR UP, IMT-CeT-2025 Examination Details ‘Subject Group for NHT-CET-2023]PGM (Physics, Chemistry and Mathematics) hitpssmhtcet2028,mahacetorg/CandidateModuletemPrintApplicationForm5121128, 1045 PM State Common Entrance Test Gel, Government of Maharashira ‘Gnguage for the Question Paper English Stats for NHT-CET-2023 Examination Center|Uttar Pradesh lDocument Uploaded. SF. No. Document Name 1 iadhaar Card Declaration 1 agree to the following conditions Ithave gone through the information Brochure and understand the eligibility ané qualfying entera [ime ierrmation filed by me ls true tothe Best of my knowledge. [Mungerstand 1 willbe lable for penal action for submiting incorrect information, lbote : 21/03/2023 lst modiied On : 21/03/2023 10:44:56 PM printed On » 2703/2023 10:45:02 PM ‘Signature of Applicant (AMIT RANJAN YADAV) htpssmhteot2028,mahacetorg/CandidaleModulesmPrintApplicationForm 22.