government of maharashtra state common entrance test …dmer.org/new/mht-cet 2016 pvt. preference...

Government of Maharashtra

STATE COMMON ENTRANCE TEST CELL, MUMBAI

PREFERENCE BROCHURE For

Admission to Private Unaided Medical and Dental Institution

NEET-UG-2016 FOR HEALTH SCIENCE COURSES

(M.B.B.S AND B.D.S)

C O MM I S SI O NE R A T E , C O MM ON E N T R A NC E T E S T C E L L , MU M BA I 305, Government Polytechnic Building, 49, Kherwadi,

Ali Yawar Jung Marg, Bandra (E), Mumbai 400 051. (M.S.) TEL NO.: +91-22-26476034 Fax No. +91-22-26476034/37

EMAIL ID : [email protected] WEBSITE: http://www.sssamiti.org

STATE CET CELL (1) NEET-UG-2016: Preference Booklet

Schedule for admission to Private Medical and Dental Institutions in the State of Maharashtra as per the Merit of NEET-UG-2016

Sr. No. Description Date

1. Online Application form for Private Medical and Dental college (Excluding Deemed University Medical and Dental Colleges)

20th August, 2016 - 24th August, 2016 (Up to 5.00 P.M.)

2. Payment of fees at SBI Branches Commencing from next working day

From 22nd August, 2016 to 25th August, 2016

3. Declaration of Provisional Merit List 27th August, 2016

4. Document verification and filling up of preference form at 4 centers

From 30th August, 2016 to 02nd

September 2016

5. Declaration of 1st (Pvt.-NEET) selection list 03rd September, 2016

6. Last date of joining as per 1st (Pvt.-NEET) selection list

09th September, 2016

7. Declaration of 2nd (Pvt.-NEET) selection list 21st September, 2016

8. Last date of joining as per 2nd (Pvt.-NEET) selection List

26th September, 2016

9. Cut-off date 30th September, 2016


INTRODUCTION: As per the directives of Hon,ble supreme court of India and the Ordinances

promulgated by the Government of India on 24/05/2016, the admission to private

Medical and Dental colleges will be on the basis of merit of National Eligibility cum

Entrance Test (UG) 2016. As per the Maharashtra Unaided Private Professional

Educational Institutions (Regulation of Admissions and Fees) Act, 2015, admission to

private unaided Medical and Dental institution will be performed by the

COMMISSIONER CET CELL, MUMBAI. The commissioner CET CELL Mumbai will be

carring out the admission process for private unaided Medical and Dental institution in

the state of Maharashtra, excluding the colleges under Deemed University.

The result of National eligibility cum entrance test (UG) 2016 (NEET-UG-2016), was

declared on 16th August, 2016. The schedule for admission to the private Medical and

Dental institutions will be as given on page number 1.

Candidate desirous for admission to Private unaided Medical and Dental

institutions (excluding colleges under Deemed University) in the State of

Maharashtra should read the following rules and ascertain his / her eligibility

before filling online application form. Selected candidates will have to pay fees as

prescribed by Shishan Shulka Samiti. (www.sspnsamiti.gov.in)

Following Are The Rules For Admission to Private Medical And Dental Institutions as

per the gazette notification.


APPLICATION FORM AND FEES FOR ADMISSION PROCESS:

1. The Competent Authority shall issue Notification regarding online Application process.

The information Brochure containing procedures for admission to private unaided

Medical and Dental courses will be made available on website of DMER www.dmer.org.

An applicant seeking admission will be required to submit single prescribed online application form (Specimen Copy of online application form is attached).

2. Candidate desirous for admission to Private unaided Medical and Dental institutions (excluding colleges under Deemed University) should read the rules and ascertain his / her eligibility before filling online application form.

3. Cost of online application form (as processing fee) for NEET-UG-2016 is Rs. 1000/- +

Rs. 60/- Bank Charges. This amount is not refundable.

4. Document verification will be conducted at Mumbai, Pune, Aurangabad and Nagpur

centres. Candidate can choose the centre for document verification as per his choice

and indicate the same in online application form. Such choice once exercised will be

final and binding.

5. The information Brochure and online application Form will be available from 20/08/2016

to 24/08/2016, before filling Online Application form candidate should download

information brochure of NEET-UG-2016 and read the same carefully. The Applicants

must possess the required criteria and education qualification as mentioned in the

Information Brochure of NEET-UG-2016.

6. Online application form filling

The details of online form submission process on DEMR website www.dmer.org are as

mentioned below.

‘Apply Online for NEET-UG-2016’ Link will be available on DMER website

www.dmer.org. Click on the above Link.

a) Application form link will be displayed. click on Application form link.

b) Instructions page will be displayed. Carefully read the Instructions for filling online

form. After reading Instructions, applicant has to click NEXT button to go to actual

Online Application form.

c) Candidate should fill all the entries in application form.

d) System will validate required fields before allowing him / her to submission.

e) During submission the application system will ask to Candidate for Password.

f) Eligible Candidate will be able to submit the form. There is provision to make changes in the Application Form before Click on Submit Button. Candidate should verify the correctness of entries made in application form. There is


no provision to make changes in the application form once Submit Button is clicked.

g) After submission of form Bank Challan will be displayed in two parts.

h) Unique Application No. (Username) along with details of nonrefundable required

fee Rs. 1,000/-+ Rs. 60/- Bank charges will be available on challan and same

details will be mailed to the Candidate on his given E-mail ID.

i) Candidate should take printout of Bank Challan. With this Challan pay the required

fee in any Branch of State Bank of India, on next Working Day onwords, from the

day of Printing Challan and obtain your copy of Challan indicating Journal

ID/Transation ID.

j) Candidate should login with Application No. (User Name) and his/her unique

Password to download the printout of Application Form. Candidate has to preserve

the downloaded printout of Application Form for subsequent use.

k) Applicants need not send copy of Application Form or any Document to this office.

l) Please note that if you commit any mistake in filling the online Application Form, it

cannot be corrected by this office. The office will take no responsibility of any kind

for such forms.

m) For any problem / difficulties in filling of this application form the candidates should

contact helpline number - 9769199421 / 9769449644 (Between 10 am to 6 pm).

7. Candidate should preserve the (i) Bank Challan (ii) Copy of downloaded Online form (iii)

downloaded copy of Information Brochure for subsequent use.

8. Candidate are required to fill the form well inadvance to avoid last day rush. They should

not wait till last date to fill the application form. Any delay due to electricity failure or due

to any technical fault will not be considered by this office.

9. At the centre so specified the candidates must bring along with them all the relevant

documents in original and one set of attested photocopies of the same for scrutiny,

alongwith HB pencil, eraser and Black ball point pen. The list of the documents is as

follows

a) Valid Photo I.D proof (Any one)- School / College ID Proof, Identity card/Adhar

card/Admit card of HSC or equivalent examination.

b) Online downloaded Application form.

c) Copy of downloaded Admit Card of NEET-UG- 2016

d) Copy of downloaded NEET-UG-2016 Statement of Marks

e) Nationality certificate issued by District Magistrate/Addl. District Magistrate or Metropolitan Magistrate (Competent Authority for issue of such certificate)/ valid Indian passport /School Leaving Certificate of HSC/12th Std. indicating the nationality of the candidate as ‘Indian’.

f) Overseas citizen of India card (OCI Card)


g) Domicile Certificate of candidates from Maharashtra State (If applicable).

h) HSC (or equivalent) examination statement of marks

i) SSC (or equivalent) passing certificate (for date of Birth)

j) SSC (or equivalent) statement of marks

k) Medical fitness certificate

The following certificates are essential to support the claim, failing which the claim will not be granted.

l) For constitutional reservation claim As per Government Resolution Dated 31 May,

2016.

(a) Caste certificate

(b) Caste Validity Certificate (CVC).

(c) Non Creamy Layer certificate (for VJ, NT1, NT-2, NT-3 & OBC including SBC) valid

up to 31/03/2017.

m) Other certificates for claiming exemption under Rule 1.7, 1.8 of Information Brochure.

General eligibility and eligibility for constitutional reservation will be finalized after

document verification. If the relevant documents are not produced by the candidate at the time

of document verification, claim will not be granted. No claim/ no change in claim will be granted

after filling of preference form.

The preference form duly filled by the candidate shall be scanned and the data thus

generated shall be given to the candidate for verification of the choices of courses / colleges

exercised by him/her. After verification the candidate will report discrepancy if any in the data

and it will be duly corrected according to his/her preference form. If the candidate does not

report at the verification counter, it will be presumed that the data entered against his/her name

is correct and corrections will not be made at later date.

The selection list will be declared on the website "www.dmer.org and www.

maha.cet.org. The candidate should joint the respective institution for which he/she has been

selected by depositing the original documents and paying requisite fees.


List of Unaided Private Medical and Dental Colleges Health Science Courses available for admission under NEET-UG-2016 By

the Competent Authority.

Candidate is requested to read the instructions at the end of the list before filling up the preference form. Admission to various Health Science Courses at the colleges shall be subject to permission/approval/affiliation from, the 1) Govt. of India; 2) Respective Central Council (MCI/DCI/CCIM etc.); 3) Govt. of Maharashtra and 4) Maharashtra University of Health Science, Nashik.

Tuition & Development Fees for private colleges is as prescribed by "Shikshan Shulka Samiti". Please refer website - (www.sspnsamiti.gov.in)

Region - Rest of Maharashtra (ROM) Faculty - MBBS

Sr. No.

College Code College Address Telephone No./Fax/ E-mail

Total Intake

Capacity Pvt.

1. 1105 K. J. Somaiya Medical College, Eastern Express Highway, Sion, Mumbai – 400 022

Tel : 022- 24091909, 24091817, 24090253 Email: [email protected]

50 Private

2. 1108 Terna Medical College, Sector – 12, Phase –II, Nerul, Navi Mumbai – 400 706

Tel : 022- 27720563, 27723664 Email: [email protected] 100 Private

3. 1139 B.K.L. Walawalkar Rural Medical College, Post.Sawarda, Tal. Chiplun Dist. Ratnagiri

Tel : 02355-264181,264636,264637 Email : [email protected]

100 Private

4. #1112

MAEER’S M.I.M.E.R. Med. College, Post. Talegaon General Hospital, Tal. Maval, Dist. Pune – 410 507

Tel: 02114–308325/ 326/332/333/339 Email : [email protected]

- Private

5. 1136

Smt. Kashibai Navale Medical College, S. No. 49/1, Off Pune – Mumbai bypass, Narhe, Dist. Pune – 411 041

Tel :- 020 – 24106271, 24106104 Email : [email protected] 150 Private

6. 1137

M.M. Patel Public Charitable trust’s Ashwin Rural Med. College, Hospital & Research Centre, At. Post- Kumbhari, Tal. & Dist. Solapur – 413 003

Tel :- 0217 – 280891 - 97 Email : [email protected] 100 Private

7. 1118

Dr. Vasantrao Pawar Medical College, Hospital & Research Center, Vasantdada Nagar, Adgaon, Dist. Nashik- 422 003

Tel :- 0253 – 303923, 2303802 Email : [email protected] 120 Private

8. 1120 A.C.P.M. Medical College, Post Box No. 145, Sakri Road, Dist. Dhule 424 001

Tel :- 02562 – 276317,18,19 Email : [email protected] 100 Private

9. 1135

Pad. V.V. Patil F’s Medical College, Opp. Govt. Milk Dairy, Vadgaon Gupta, M.I.D.C., Dist. A’nagar – 414 111

Tel : 0241 – 277059, 2778042 Email : [email protected]

150 Private

10. 1138

Dr. Ulhas Patil Medical College, Gat No. 315, 316, 321 & 305 a part, Jalgaon – Busawal Road, Jalgaon Kh., Tal. & Dist. Jalgaon- 425 309

Tel : 0257- 3058557 Email : [email protected] 150 Private

11. 1143

Prakash institute of medical sciences & research, Islampur- Sangli Road, Islampur. Tal- Walwa, Dist- Sangli - 415409.

Tel : (02342) 662300 To 662309 Fax- (02342)662323 Email : [email protected]

150 Private


Sr. No.


Total Intake

Capacity Pvt.

12. 1144

S.M.B.T.Institute of Medical Sciences & Research, Nandihills, Dhamangaon-Ghoti, Tal. Igatpuri, Dist.Nashik-422403

Tel:- 02425 -225434 Fax:- 02425-222867 Email : [email protected]

150 Private

13. *1146

Institute Of Medical Sciences And Research, Vidyagiri, Vita Road, Mayani, Tal.- Khatav,Dist. - Satara -415102

Tel:- 02161- 270661, 270761. Email : [email protected] [email protected]

- Private

Region - Vidarbha Faculty - MBBS

14. 1223 N.K.P. Salve Institute of Med. Sciences, Near C.R.P.F. Campus, Digdoh Hills, Nagpur

07104 – 306100, 236290-91 Email: [email protected] 150 Private

15. 1225 Dr. Punjabrao Deshmukh Smruti Med. College, Shivaji Nagar, Dist. Amravati – 444 603

Tel.: 0721 – 2552353, 2662323 Email:- [email protected] 100 Private

Region - Marathwada Faculty - MBBS

16. 1330 M.I.M.S.R. Medical College, Vishwanathpuram, Ambejogai Road, Dist. Latur – 413 531

Tel :- 02382 – 227422/ 24, 227028, 227587 Email : [email protected], mimsr.@mimsr. edu.in

100 Private

17. 1345

JIIU’s Indian Inst. of Med. Scien. & Research, At. Warudi, Post. Gevrai Bazar, Tal. Badnapur, Dist. Jalna – 431 202

Tel :- 02482 - 222515 Email:- limsr11gmail.com 100 Private

(Minority)

(Private Colleges)

Region - Rest of Maharashtra (ROM) Faculty - BDS Sr. No.


Total Intake

Capacity Pvt.

1. 2115

Dr. G. D. Pol Foundation, Y.M.T. Dental College & Hospital, Institutional Area, Sector – 4, Kharghar, Navi Mumbai – 410 210.

Tel: 022-27744429, 2774405, Fax: 22- 27744427 Email : [email protected]

100 Private

2. 2122

T.P.C. T.’s Terna Dental College & Hospital, Plot No. 12, Sector – 22, Phase – II, Nerul (W), Navi Mumbai – 400 706.

Tel: 022-27721839 /27721698 Email : [email protected] 100 Private

3. 2123

M. G. M.’s Dental College & Hospital, Junction of NH-4 & Sion – Panvel Expressway, Sector 18, Kamothe, Navi Mumbai – 410 209.

Tel: 022-27436604 / 27433185 Email : [email protected] 100 Private

4. 2127

Yogita Dental College & Hospital, Near Narangi Bridge, Dapoli Road, A/P. Tal. Khed, Dist. Ratnagiri- 415 709.

Tel: (02356) 261144, 264534, 261144 Email : [email protected]

100 Private

5. 2128

Shan Edu.Society’s Guardian College of Dental Sciences & Research Centre, Ambarnath (W), Dist-Thane - 421 301

Tel :- (0251) 2686187/2686179 Email : gcdsrc.gmail.com 100 Private


6. 2104 Vasantdada Patil Dental College & Hospital, A/P, Kavalapur, Tal. Miraj, Dist. Sangli – 406 306.

Tel : (0233) 2364400, 02/ 2364404 Email : [email protected]

40 Private

7. 2119

M. A. Rangoonwala College of Dental Sciences & Research Centre, 2390- B, K. B. Hidayatullah Road, Azam Campus,Camp, Dist. Pune – 411 001.

Tel : (020) 26430959, 60, 61 Email : [email protected] 100 Private

(Minority)

8. 2118 P.D.U. Dental College, 19/1, Kegaon, Dist. Solapur – 413 255.

Tel : (0217) 3243937, 2500440 (0217) 2500613 Email : [email protected]

100 Private

9. 2120

Tatyasaheb Kore Dental College & Research Centre, Mahatma Gandhi Hospital Campus, New Pargaon, Tal. Hatkanangale, Dist. Kolhapur – 416 137.

Tel : (0230) 2477081, 82 (0230) 2477654, 2477082 Email : [email protected]

60 Private

10. 2124

Sinhgad Dental College & Hospital, S. No. 44/1, Vadgaon (BK.) Off. Sinhgad Road, Dist. Pune – 411 041.

Tel : (020) 24351307, 24351303 (020) 24351308 Email : [email protected]

100 Private

11. 2116 D.Y. Patil Dental School, Dr. D.Y. Patil Knowledge City, Charholi (BK), Via.Lohegaon, Pune–412105

Tel : (020) 30612700 / 306 12718 Email :- [email protected]

100 Private

12. 2105 MGVM’s KBH, Dental College & Hospital, Mumbai – Agra Highway, Panchvati, Dist. Nashik – 422 003.

Tel: (0253) 2514873, 2628178 2517354 Email : [email protected]

100 Private

13. 2117

Sau. Mathurabai Bhausaheb Thorat Dental College & Hospital, Sangamner, Dist. Ahmednagar – 422 608.

Tel : (02425) 225434 / 222867 Email : [email protected]

100 Private

14. 2121 JMF’s A. C. P. M. Dental College, Opp. Jawahar Soot Girni, Sakri Road, Dist. Dhule- 424 001.

Tel : (02562)277924, 279924 (02562)279924 Email : [email protected]

100 Private

15. 2134

Late Shri. YCM Dental College & Hospital, 166/1, Vadgaon Gupta, Opp. M.I.D.C., Dist. Ahmednagar – 414 003

Tel : (0241)2779111, 6450365 (0241) 2778511 Email : [email protected]

100 Private

Region - Vidarbha Faculty - BDS

16. 2212 VSPM’s Dental College, Near C. R. P. F., Digdoh Hills, Hingna Road, Dist. Nagpur - 440 019.

Tel : (07104) 306100, 306200, 01,03,306202 Email: [email protected] [email protected]

100 Private

17. 2211 V. Y. W. S. Dental College & Hospital, Tapovan - Wadali Road, Camp, Dist. Amravati – 444 602.

Tel : (0721) 2662166 /2666490 2660752 Email :[email protected]

50 Private

18. 2230

Swargiya Dadasaheb Kalmegh Smruti Dental College & Hospital, Wanadongri Road, Hingna, Dist. Nagpur - 441 110.

Tel: (07104) 321782 /280556 256836 / 280099 Email : dadasahebkalmeghadetal @yahoo.com

100 Private

19. 2229

Dr. Rajesh Ramdasji Kambe Dental College & Hospital, Tal.Barshitakli, Gat No. 228, At. Po.- Kanheri (Saraf), Tal.- Barshi Takali, Dist.- Akola – 444401

Tel:- (07256) 242144 Email : [email protected] 100 Private

STATE CET CELL (21) NEET‐UG‐2016: Preference Booklet

Region - Marathwada Faculty - BDS

20. 2314 C.S.M.S.S.’s Dental College & Hospital, Kanchanwadi, Paithan Road, Dist. Aurangabad – 431 002

Tel : (0240) 2379248 /6646464 2379035 / 6646222 / 2379355 Email : [email protected]

100 Private

21. 2325

Maharashtra Institute of Dental Sciences & Research, Dental College, Vishwanath Puram, Ambejogai Road, Dist. Latur – 413 512.

Tel: (02382) 227703, 228063, 227424 228063, 227063, 228939 Email : [email protected]

100 Private

22. 2331 Aditya Dental College, Sarda Estate, Pimpalner Road, Suraj Nagar, Dist. Beed – 431 122.

Tel : (02442) 2204021 / 22 227061 Email: [email protected]

100 Private

23. 2326

Saraswati Dhanwantari Dental College & Hospital, Pathri Road, NH – 222, Dist. Parbhani – 431 401.

Tel: (02452) 240101, 221746 223096 Email : [email protected]

100 Private

24. 2332

Dr. Hedgewar Smruti Rugna Seva Mandal’s Dental College & Hospital, Basamba Phata, A kola Road, Dist. Hingoli – 431 513.

Tel: (02456) 287252, 224036 Email : [email protected] 50 Private

25. 2333

Nanded Rural Dental College & Research Centre, Pangri Village, Behind S.R.T.M. Univ., Tq. & Dist. Nanded- 431 606

Tel : 7745000777 Mail : [email protected] [email protected]

100 Private

Note: 1) This information is as on 18/08/2016. 2) Admission to various Health Science Courses at the colleges shall be subject to

permission/approval/affiliation from, the (1) Govt. of India; (2) Respective Central Council (MCI/DCI/CCIM etc.); (3) Govt. of Maharashtra and (4) Maharashtra University of Health Science, Nashik. Candidate will be admitted to a given course and college if the permission from all the above authorities has been granted on the day of allotment of seat.

# Recognized for 100 seats. Not permitted by MCI for renewal of permission for increase of seats from 100 to 150 u/s 10(A) for 2016-17. Admission stopped against recognized intake of 100 seats and increase intake of 100-150 seats for year 2016-17

* Not permitted for renewal of permission u/s 10(A) for 2016-17 by MCI. *** *** ***


UNDERTAKING FOR CASTE VALIDITY CERTIFICATE (As per Government rules to regulate the admissions to the First year of the Full Time

Professional Medical and Dental Undergraduate Courses, in the Unaided Private Professional Educational Institutions in the State of Maharashtra, rule no 12.1(d))

I, Mr/Mrs. _____________________________________________________ (Student's Full

Name), NEET-UG 2016 State Rank. ___________________________________. NEET-UG-

2016, applying for Health Science Courses as per Merit List. I belong to

_________________________ (Name of Caste and Category), my caste Certificate No.

________________________, which is issued by _____________________________. I have

applied for caste validity certificate to the office of

_________________________________________________________________________ on

dated _________________. Till date i have not received caste validity certificate or there is no

order or instructions about my claim of caste from the respective said office.

I undertake that, my admission against reserved seat is subject to submission of caste

validity certificate and if may claim is invalidated. I shall not claim any equity on account

of admission against the reserved seat. I also state that, in the event of my claim as

belonging to reserved category is invalidated. I shall refund the amount of scholarship

received by me, to the State Government. I state that i am aware of the fact that, my

admission is subject to the validation of my caste certificate by the Caste Scrutiny

Committee and on invalidation, my admission is liable to be cancelled.

Name and Sign of Student Name and sign of Parent

Date:


PROFORMA FOR MEDICAL FITNESS

A candidate must be medically fit to undergo the professional course applied for. The medical fitness must be certified by a Registered Medical Practitioner in the prescribed proforma, as

given below on a Letterhead :

CERTIFICATE OF MEDICAL FITNESS

This is to certify that I have conducted clinical examination of Mr./Ms

.............................................................. who is desirous of admission to Health Science Courses.

He/she has not given any personal history of any disease incapacitating him/her to

undergo the professional course. Also, on clinical examination it has been found that he/she is

medically fit to undergo the professional course.

Certified that he/she fulfills the following criteria.

(1) Absence of any incapacitating and /or progressive systemic disease/disorder/condition, (2) Absence of any disability of upper limb/s. (3) Absence of any major visual/ auditory disability. (4) Absence of psychosis/neurosis/mental retardation, (5) Ability to maintain erect posture, (6) Reasonable manual dexterity.

Though, following deviations have been revealed, in my opinion, these are not impediments

to pursue a career as a Medical / Dental / Ayurved / Unani / Occupational Therapy /

Physiotherapy / Audiology & Speech, Language Pathology / Prosthetics & Orthotics / BSc

Nursing. (Strike, which is not applicable):

1. ...................................................................................................................

2. ...................................................................................................................

3. ...................................................................................................................

Address of the Registered Medical Practitioner

Date :

Signature

Name

Registration No.

Seal of Registered Medical Practitioner


Government of Maharashtra

ST AT E COM MON E NTR ANC E TE ST CELL , MU M BAI NEET-UG-2016 - Preference Form System

SCRUTINY FORM

Candidate's Name : __________________________________________ NEET -UG-2016 State Rank _________

Date of Birth : ____________________ NEET Roll No.: _________________NEET Application No._____________

Category : _____________ Region Code : ____________ My religion is _____________________________

HSC PCB :

Signature of Candidate (Arrange a set of original certificates and one set of attested photocopies separately in the order given below for verification)

Remarks : (For Office Use only)

Eligible : Yes / No If not eligible, reason/s ____________________

Signature of Scrutiny Clerk ________________________________________ Any other remarks : ______________________

________________________________________

________________________________________

Name & Signature of Scrutiny Officer

ONLINE APPLICATION FORM

APPLICABLE FOR RESERVED CATEGORY CANDIDATES (EAR-MARKING) :

In pursuance of the "Ear-Marking Rule" (with reference to

information brochure for Preference system), I hereby exercise my option

and opt for seat as and when I am found entitled to admission

on the basis of merit in an open category seat, as per my Preference form.

Date : / / 2016 Signature of Candidate

Valid photo ID - School / College

Online downloaded Application form

Copy of downloaded Admit Card of NEET-UG- 2016

Copy of downloaded NEET-UG-2016 Result.

Nationality certificate/valid Indian passport/School leaving certificate

Domicile Certificate of candidates (If required)

Overseas citizen of India card (OCI Card) H.S.C. (or equivalent) examination marksheet

SSC (or equivalent) passing certificate

SSC (or equivalent) statement of marks

Medical fitness certificate

If applicable

Caste Certificate

Caste Validity Certificate

Non Creamy layer Certificate valid upto 31/03/2017 (VJ, NT1, NT2, NT3 & OBC including SBC)

Scrutiny Officer

--------------------- (Reserve/Open)

NEET-UG-2016 All india Rank: ______________

______/300 ______/100 HSC E

NEET-UG-2016 Percentile Score: ______________


Status Retention Form (To be sent to Competent Authority by the college)

Candidate’s Name : _________________________________________________________

NEET-UG-2016 All india Rank ____________ NEET-UG-2016 State Rank _____________

Category : __________ NEET-UG-2016 Roll.No. : _________________

Address: ___________________________________________________________________

______________________Pin Code:______________Phone No.______________________

To The Competent Authority, NEET-UG-2016, Mumbai.

Sir/Madam, I, Mr./Miss______________________________________ wish to retain the seat allotted

(Name of Candidate)

to me at _______________________________________________________________________ (Name of the College)

for MBBS/BDS Course for the academic year 2016-17. Declaration

I am fully aware that after filling this Status Retention Form that I will not be considered for any subsequent rounds of selection process for the year 2016-2017. I also declare that I will not ask for reconsideration of my name for further selection process.

Date : Place : Signature of Candidate Signature of Parent/Guardian Signature of Dean /Principal (with seal) (Cut here)

(To be retained by the College) To The Competent Authority, NEET-UG-2016, Mumbai.

Sir/Madam, I, Mr./Miss______________________________________ wish to retain the seat allotted

(Name of Candidate) to me at _______________________________________________________________________

(Name of the College)

for MBBS/BDS Course for the academic year 2016-17.

Declaration I am fully aware that after filling this Status Retention Form that I will not be considered for any subsequent rounds of selection process for the year 2016-2017. I also declare that I will not ask for reconsideration of my name for further selection process.

Date : Place : Signature of Candidate Signature of Parent/Guardian Signature of Dean /Principal (with seal)


PROFORMA FOR CANCELLATION OF ADMISSION (To be filled in duplicate)

To, The Dean / Principal, ___________________________

___________________________

Subject : Cancellation of Admission.

Respected Sir,

I, Mr./Ms. ………………………………………………………………………………….......

SML No. ……………………….. was admitted to ……………………………………………….....

course, at ………………………………………………………………………………………….......

college ………………………………………………………. on …………………………………....

(date) under …………………………………. category.

Now I wish to cancel my admission since

1) I have secured admission through another Competent Authority for Engineering/

Architecture / Agriculture / Any other course …………………………………………......

2) I wish to cancel it for personal reason/s.

I hereby request you kindly return my original documents and the amount of fees that I

am entitled for, as per rules.

Thanking you,

Yours faithfully,

(Signature of Candidate)

Name & Address of candidate

…………………………………………………

…………………………………………………

…

Pin Code ………………………

Tel. No. ……………………….

For Office use only:

Amount Paid Rs. ……………………….

Amount deducted Rs. …………………..

Amount refunded Rs. …………………..

Cheque No. & date ……………………..

Bank particulars …...…………………...

Enclosure : Photocopy of selection letter from another Competent Authority (if applicable)


Specimen Copy of Online Application Form

government of maharashtra state common entrance test …dmer.org/new/mht-cet 2016 pvt. preference...

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