22322
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NoMaritial Status
Dhangar (29)Caste Sub Caste
NoIs Applicant
Salaried ?
0.00Applicant's Annual
Income
25000.00Total Annual
Income
B.Sc(C.S.) 2011 69
Mahatama Jyotiba Phule College of Comp.Sci.& Information Technology,Chousala Tq.Di
Last Exam MarksLast Exam Passed
Year
Last attended School/College/Institute
Last Exam
Passed
Master of Business Administration
2011-2012
05-08-2011 06-08-2011
Government Quota
NoIs Fees Paid ?
Quota
Academic Year
Joining DateDate Of
Admission
Subject
Course Name
first name middle name last name
C107589SSC Seat No
MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATIONSSC Board
2004Passing Year
Fee Receipt No.
Fee Receipt Date
59.46SSC Marks Obtained
Student SSC Details
Applicant's Details
NoOr han
YesHas Applied For
Hostel ?
Please
Paste
Pasport Size
Photograph
Student Prequalifying Details
Institution Details
2011-2012Academic Year
05/08/2011College Admission
Number
Application Form
Vimukta Jat Nomadic TribesCaste Category
Appilcation type New
04-10-2011Application Date
Applicant Name ANIL MANOHAR MARKAD AsrabaiMother's Name
Is Resident of
Maharashtra
Maharashtra25-06-1988Date of Birth Gender Male
Name of School/College/Institute where
Admitted
Rajarshi Shahu Institute of Management, Aurangabad - 431210
Is Staying at
Hostel ?
No
Disabilit T e
Fee Paid
Course Year
Passed
0.00
1
Yes
N.A.Is Disabled No
N.ARenewal Course Year
Is Admission after
Di loma
No
APPC1075891M20042011Application Number
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Residential Number: N.A, MobileNumber: 8390138912, EmailAddress: Anil.mmarkad@rediffmail.com
Address:- At.Tartewadi Post.Shirasmarg Tq.Georai Dist.Beed Location:- Tartewadi City:- Shirasmarg
Pincode:- 431127 Taluka:- Georai District:- Beed
ScrutinyCommittee No
Dec.No.C.Dec./B-334
Parent
Age
47
Issued in 2011
AurangabadDistrict IssuingOffice
Taluka Issuing
Office
GeoraiCaste Certificate
No
Income Certificate
No
Caste ValidityCertificate No
No.D 6274
No.2002/Misc/CR/1
54
District Issuing
Office
Beed
IN-739
University
Re istration No
Document Details
Is Studying in night
school
No
Hostel/ Landlord
Address
N.A Hostel/Landlord
Contact Details
N.A
Hostel Admission
Date
N.AName of Landlord /
Hostel
N.A
N.A Is Mess Service
Available?Rent Per MonthNoHostel Type
Hostel Information
Parmanent Address At.Tartewadi Post.Shirasmarg Tq.Georai Dist.Beed
Parent's nameMANOHAR
middle name
KISANRAO
last name
MARKAD
Relation with
Applicant
Father Profession
Parents Annual
Income
25000.00
Farmer
first name
(yrs)
Parent / Guardian Details
Address For Correspondence
Contact Details
Student Bank Account Details
STATE BANK OF HYDERABAD
GEORAIBranch Name
62165995531Bank Account NoBank Name
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Document Attached
Applicant Parent's SignatureApplicant's Signature
The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.
Principal's Signature
Declaration
Caste Certificate Issued by Competant Officer
Income Proof - Income Certificate Issued by Competant Authority
Marksheets
I-card Size Photo
Caste Validity Certificate
District Transfer Certificate
Non-Crimiliar Certificate
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