REGISTRATION FORM
FOR
FIRST YEAR DIPLOMA ADMISSION
Name
:
Full Address
:
Phone :
Mobile :
Email :
Category
Open
SC
ST
VT/DT
NT1
NT2
NT3
OBC
SBC
OMS
Gender
Male
Female
SSC Marks
Grand Total
Out of
Percentage
*
HSC / CBSE or Equivalent (With minimum 50% in PCM)
PCM Marks
Out of
% PCM
Grand Total
Out of
**
Diploma Course in Engineering Tech.
Marks Obtained
Out of
Percentage
Branch
State
Branches Preference
0
1
2
3
4
5
Civil Engg.
0
1
2
3
4
5
Mechanical Engg
0
1
2
3
4
5
I.T.
0
1
2
3
4
5
Computer Sci. & Engg
0
1
2
3
4
5
Electronics & Tele-communications
Candidature type
A : SSC & HSC both from the Maharashtra State
B : Parent Domiciled in the Maharashtra State
C : CG employee posted in the Maharashtra State
D : SG employee posted outside the Maharashtra State
E : SG employee transferred to another university Area.
Type of Candidate
:
A : Maharashtra State Candidate
B : Maharashtra Domicile Candidate
C : Outside Maharashtra State
Belong Economical Backward Class
:
Yes
No
Do you have Caste Certificate stating caste is recognized under reserved category in Govt. of Maharashtra state ?
:
Yes
No
Do you have Caste Validity Certificate issued by Authority of Govt. of Maharashtra state ?
:
Yes
No
Do you have Non Creamy Layer Certificate issued after 1st April 2004 by an Authority of Govt. of Maharashtra State ?
:
Yes
No
*
with English Subject
**
English Medium