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Application Form for Admission at Walchand College of Engineering, Sangli for the Academic Year 2020 – 2021

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Application Form for Admission at Walchand College of Engineering, Sangli for the Academic Year 2020 – 2021 Dear Sir / Madam, Reg. : Admission at Walchand College of Engineering, Sangli. As requested by you, we are forwarding herewith Personal Data Form along with Application Form for Admission at Walchand College of Engineering, Sangli for the Academic Year 2020 – 2021. While submitting the Personal Data Form & Application Form, please submit the Attested Copies of the following Certificates: 1. Certificate of Marks (Mark List) obtained at the qualifying examination H.S.C. (Std. XII). 2. School Leaving Certificate, after qualifying examination passed. 3. Certificate of Marks (Mark List) obtained at S.S.C. (Std. X) or its equivalent examination. 4. If S.S.C. / H.S.C. passed outside Maharashtra, Maharashtra Domicile Certificate in respect of his / her father. 5. Copy of MHT - CET – 2020 / JEE – 2020 Result. 6. Fill up CAP Form and submit us the acknowledgement copy issued by CAP Authority. Please return the (Hard Copy) Application Form, Personal Data Form duly filed alongwith the certificates as mentioned below to: Mr. Umesh M. Masurkar Hindustan Construction Co. Ltd., Hincon House, LB Shastri Marg, Vikhroli (W), Mumbai – 400 083. Tel.No.: 2575 5248 For SETH WALCHAND HIRACHAND MEMORIAL TRUST Authorised Signatory APPLICATION FOR NOMINATION FOR ADMISSION TO FIRST YEAR OF THE FOUR YEAR ENGINEERING DEGREE COURSE IN THE WALCHAND COLLEGE OF ENGINEERING, SANGLI. SETH WALCHAND HIRACHAND MEMORIAL TRUST HINCON HOUSE, LAL BAHADUR SHASTRI MARG, VIKHROLI ( WEST ), MUMBAI 400 083. PERSONAL DATA ( TO BE FILLED BY EMPLOYEE ) Full Name (Block Letters) : ……………………………………………………………………………………………………… Department / : Branch : : ……………………………………………………………………………………………………… Designation : ……………………………………………………………………………………………………… Date of Joining : ……………………………………………………………………………………………………… Total Years of Service : ……………………………………………………………………………………………………… Relation with Candidate : ……………………………………………………………………………………………………… Mailing Residence Address (Full): Faculty Desired ( Compulsory ): ______________________________ 1st Preference: ________________ ______________________________ 2nd Preference: ________________ ______________________________ 3rd Preference: ________________ ______________________________ ______________________________ Phone No. :_____________________ Mobile No. :_____________________ Marks Obtained in 12th Standard: Aggregate : & % PCM : & % MHT-CET – 2020 Score : __________ JEE 2020 Score : __________ _________________ ( Employee Signature ) APPLICATION FOR NOMINATION FOR ADMISSION TO FIRST YEAR OF THE FOUR YEAR ENGINEERING DEGREE COURSE IN THE WALCHAND COLLEGE OF ENGINEERING, SANGLI. SETH WALCHAND HIRACHAND MEMORIAL TRUST HINCON HOUSE, LAL BAHADUR SHASTRI MARG, VIKHROLI ( WEST ), MUMBAI 400 083. PERSONAL DATA ( OUTSIDERS ) Full Name (Block Letters) : ……………………………………………………………………………………………………… Relation with Candidate : ……………………………………………………………………………………………………… Mailing Residence Address (Full): Faculty Desired ( Compulsory ): ______________________________ 1st Preference: ________________ ______________________________ 2nd Preference: ________________ ______________________________ 3rd Preference: ________________ ______________________________ ______________________________ Phone No. :_____________________ Mobile No. :_____________________ Marks Obtained in 12th Standard : Aggregate : & % PCM : & % MHT-CET – 2020 Score : __________ JEE 2020 Score : __________ _______________ ( Parents Signature ) APPLICATION FORM Admission to Four Year Degree Course in Engineering / Technology in the Autonomous Institutes for the academic year 2020-21 Application Form No.: Registration No.: (write down Registration No. at the time of submitting online application forms) 1. Personal Details Full Name (As appeared in MHT-CET 2020 Exam) Paste your Recent Passport Surname First Name Father’s Name Mother’s Name Photograph Gender: (Male / Female) __________________ Date of Birth ____ / ____ / _____ DD / MM / YYYY Address for Correspondence: _________________________________________________________ _________________________________________________________________________________ Tel. No.: (with STD): Mobile No.: e-mail: 2. Qualification and MHT-CET Details Marks & % (To be verified at the Application Receipt Centre) MHT-CET 2019 Roll No.: CET Score & %: / / CET Maths Marks & %: _____ / _____ CET Physics Marls & %: _____ / _____CET Chemistry & % _____ / _____ HSC Total Marks & %: _____ / _____ HSC PCM Marks & % : _____ / _____ SSC Total Marks & %: _____ / _____ SSC Maths Marks & % : _____ / _____ 3. Type of Candidate (Refer Brochure) a) Candidature Type A/B/C/D : Caste Category : (Open / SC/ST/VJ-NT-A / NT-B / NT-C / NT- D/OBC / SBC) b) Are you from Special Backward Class (SBC)? : (Yes / No)____________ If yes, Caste : ____________ (In case of SBC candidates the original category shall be decided from caste) c) Do you have income certificate (Less than 2.5 Lakhs) ? (Yes / No)____________ d) Do you have Non-Creamylayer Certificate ? (Yes / No)____________ (other than OPEN/SC/ST) e) Is the candidate physically Handicapped? (Yes / No)____________ (disability more than 40%) f) Is the candidate from Defence Quota (Yes / No)____________ (D1/D2/D3) Declaration: I certify that the information given above is correct and I am aware that providing incorrect information in the application form will result in the cancellation of my admission at any time to the institute. Date: Place: ___________________ Signature of Candidate (For Office Use Only) Form Fees Received, Amount Rs. ____________________________________ Date : ____ / ____ / 20____ Application Form No.: __________________________ Sign of Scrutiny Officer:____________________ Sign of ARC Officer :____________________.
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