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Select Junior College Stream:

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Student Name:

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Student E-mail:

Student Mobile Number:

Student Address:

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Gender:

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Date of Birth:

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2015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901

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month

year

Parent Name:

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Select Category:*

SC

ST

DT

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Jain Minority

OPEN

Religion*

(You have to submit Religion Certificate if you are from other than Open category)

Passing Examination:

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Outside Maharashtra

NRI / PIO / Foreign

Nationality:

Passport Number:

Passport Valid Upto date:

Visa Type:

Visa No:

Visa Valid upto:

Any Board exam Given:

Educational Details - X^th:

10th Board

10th - Year of Passing:

10th - Marks in %:

Educational Details - XI^th:

11th - Stream

%31 - 11th - College:%

%32 - 11th - Board:%

11th - Year of Passing:

11th - Marks in %:

Is hostel and mess facility required?:

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