How to Fill Form Fields / फॉर्म कसा भरावा Field Number

Section

Field Name

Description

1

Personal

Candidate is Domicile of Maharashtra ( आपण

Please select Yes or No

2 3

Personal Personal

4

Personal

आ Salutation

?)

First Name / नाल Middle Name/ लडीराांचे

नाल /ऩतीचे नाल

Please select your Salutation Please Enter Your Name तभ ु चे नाल बया

Please enter your Father's or Husband's Name

लडीराांचे नाल /ऩतीचे नाल बया

5

Personal

Last Name/ आडनाल

Please Enter Your Surname

6

Personal

Date of Birth/ जन्भ तायीख

Please Enter Date of Birth According to Leaving Certificate

तभ ु चे आडनाल बया

तभ ु ची जन्भ तायीख बया

7

Personal

Gender/ लरांग

8

Personal

Email इभेर

9

Personal

Telephone (Landline)

Please Enter Email इभेर Please Enter Telephone no

10

Personal

Mobile No 1

Please Enter Mobile Number for Communication

11

Personal

Mobile No 2

Please Enter Mobile Number for Communication

12

Personal

House No/Colony 1 ( घय क्रां. /

Please Enter House No/ Colony of your Residence घय नां. / लवाशत

पोन न. भोफाईर भोफाईर

लवाशत )

Please Select Gender Male or Female ऩरु ु ऴ / ीरी /

पोन न. भोफाईर भोफाईर

13

Personal

Major Landmark 2(ऩत्ता )

Please Enter Major Landmark of your Residence घया जलऱची खूण

14

Personal

State (याज्म )

Please select your State (याज्म )

15

Personal

District जजल्शा

Please Enter District of Your Residence

16

Personal

Taluka तारक ु ा

Please Enter Taluka of Your Residence

जजल्शा

तारुका

17

Personal

City/Town/Village

Please Enter City/Town/Village of Your Residence

(ळशय /

तारुका / गाल )

(ळशय /

तारुका / गाल )

18

Personal

Pin Code पऩन कोड

Please Enter Pin Code of your Residence

19

Personal

Father First Name

Please Enter Name of your Father

20

Personal

Father Middle Name

Please Enter Middle Name of Your Father

21

Personal

Father Last Name

Please Enter Last Name of Your Father

22

Personal

23

Personal

Father/Guardian Occupation लडडराांचा व्मलवाम Mother First Name

Please enter Occupation of Father/Guardian लडीर अथला ऩारक माांचा व्मलवाम Please Enter Name of your Mother

24

Personal

Mother Middle Name

Please Enter Middle Name of your Mother

25

Personal

Mother Last Name

Please Enter Surname of your Mother Before Marriage

लडडराांचे नाल

लडडराांच्मा लडडराांचे नाल लडडराांचे आडनाल

आईचे नाल

आईच्मा लडडराांचे नाल आईचे रग्नाआधीचे आडनाल

26

Reservations

Are you Army Person ?

27

Reservations

Category

भुख्म आयषण जात/ प्रवर्म

पऩन कोड

लडडराांचे नाल

लडडराांच्मा लडडराांचे नाल लडडराांचे आडनाल

आईचे नाल

आईच्मा लडडराांचे नाल

आईचे रग्नाआधीचे आडनाल

Please select if you are working/ worked in Army. आपण आ ? Select Appropriate Category, You will have to submit required documents as Proof

भुख्म आयषण जात / प्रवर्म 28

Reservations

Other Reservation

Please select Appropriate option

29

Reservations

Caste

Please enter your Caste according to Leaving Certificate

30

31

Reservations

Reservations

इतय आयषण जात

Sub Caste

ऩॊतजात

Do you have non Creamy Layer Certification?

नॉन क्रेभी प्रभाणऩर आशे काम ?

इतय आयषण जात

Please enter your Sub Caste according to Leaving Certificate

ऩोटजात Please select yes or No based on Creamy Layer Certificate, you would have to submit proof along with Application

नॉन क्रक्रभी रेअय प्रभाणऩर आशे काम ?

32

Reservations

Do you belong to EBC?

ई.वी .फी . प्रभाणऩर आशे

काम ?

Please select Yes or No based on if You have EBC Certificate. You would need to submit proof Of EBC document. ई.वी .फी . प्रभाणऩर आशे काम ?

33

Academic

Highest education Qualification

You should have completed Diploma

34

Academic

Month & Year of Passing

Please Enter Month & Year of Passing of Diploma Exam

ऩाव शोण्माचे भहशना आणण लऴष

35

36

Academic

Academic

Institute Name

/

Institute District

/

DIPLOMA ऩाव शोण्माचे भहशना आणण लऴष Please Enter Name of your Institute for HSC

/ Please Enter District of Your Institute

जजल्शा

/

जजल्शा 37

Academic

Month & Year of Passing

ऩाव शोण्माचे भहशना

Please Enter Month & Year of Passing of SSC Exam

ऩाव शोण्माचे भहशना आणण लऴष

आणण लऴष 38

Academic

No of Attempts

Diploma ऩयीषा क्रकती लेऱा हदरी ?

39

39A

Academic

Academic

Total SSC Marks ण Total Diploma Marks Diploma ण

Please Enter No of Attempts of your HSC Examination

Diploma ऩयीषा क्रकती लेऱा हदरी ? Please enter total marks obtained in SSC Exam

ण

Please enter total marks obtained in Diploma Diploma

ण

40

Preference

District of Choice

Select District of Your Choice

41

Preference

Select Preference District Supporting Document

42 43

Preference Preference

Preference District Supporting Document Taluka of your Choice Authorized Center Code अधधकृत केंद्र

43A

Preference

Preference Code ऩवांती क्रभ ननलडा

Please select preference codes according to your college Preference. ऩवांती क्रभ ननलडा

44

Documents

Photograph तभ ु चे छामाधचर

Please upload your passport size photograph तभ ु चे छामाधचर अऩरोड कया

Taluka of your Choice Please enter Authorized Center Code Value. अधधकृत केंद्र ननलडा

45

Documents

Document CheckList पॉभष वोफत जोडण्माची कागदऩरे

Please tick appropriate document to be attached with form. तभ ु ची पॉभष वोफत जोडण्माची कागदऩरे ननलडा