* required field.
Course admitted to:
I.D. No:
Roll No:
Form No:
Admission Date:
Use blank ink pen to fill in the form and do not overwrite.
Fill in all fields in CAPITAL letters only.
Strike-off whichever is NOT applicable.Eg.if you are a male/female
course applied for(e.g I.T./B.M.S./C.S.):
course part of semester applied for(e.g |/||/|||..):
Student should sign strictly inside this box only with black ink.
Name Of the student: (in case of changed name,write current name)
Name Of the student: (in Devnagari (Marathi) script)
Name Of the student: (As printed on std.10th passing certificate)
Father/Husband's name:
Mother's name:
Previous name of student: (in case of changed name)