7.2.1 Describe Two Best Practices Successfully Implemented by the Institution As Per NAAC Format Provided in the Manual

Vidya Mandir Mandal’s Matoshree Sumati Chintamani Tipnis College of Arts and Commerce Mamdapur-Neral,Tal-Karjat, Dist-Raigad.

7.2.1 Describe two best practices successfully implemented by the Institution as per NAAC Format provided in the Manual.

Title of the Practice: Financial Relief through installments of fees

The Number of students availed this benefit in last Five Years are as follows

Year 2018-19 2017-18 2016-17 2015-16 2014-15 Total Number of students 88 80 33 15 12 228 benefited

List of students benefited by this practice

Title of the Practice: Assistance in Online Scholarship Form Filling

The Number of students availed this benefit of online scholarship form filling in last Four Years are as follows

Year 2018-19 2017-18 2016-17 2015-16 Total Number of students 93 201 72 57 423 benefited

SCHOLARSHIP FORMS OF 2015-16 Application Form

Printed on 2/27/2016 10:34:00 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1769644M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176964 SSC Marks Obtained 42.20

Applicant's Details

Applicant Name MAHENDRA BHARAT AINKAR Mother's Name BHARATI

Date of Birth 05-05-1998 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 09-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 40000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NERAL VIDYAMANDIR JR 12th (Arts) 1 46.15 Pass COLLEGE NERAL 2013 - 14 NERAL VIDYAMANIDR JR 11 th Arts 2 45.00 Pass COLLEGE NERAL 2012 - 13 KES PRAGATI MADHYAMIK SSC 1 42.20 Pass VIDYALALA KALAMB Institution Details

Name of School/College/Institute where Admitted Vidya Mandir Mandal"s Matoshree Sumati Chintamani Tipnis College Of Arts & Commerce,At Mamdapuir,Neral,Tal-Karjat,Dist-Raigad-410101 Course Name Bachelor of Arts Course Year 1

UID Number 208883483809 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 1002 Quota Government Quota Joining Date 20-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 8805849752, EmailAddress: [email protected]

Address For Correspondence

Address:- AINKAR NIVAS Location:- KARJAT MURBAD ROAD City:- Kalamb Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name BHARAT JAYVANT AINKAR Age 38(yrs) Relation with Applicant Father Profession Labor

Parmanent Address AINKAR NIVAS Location:- KARJAT MURBAD ROAD City:- Kalamb Pincode:- 410101 Taluka:- Karjat District:- Raigarh Is Father Alive? Yes Annual Income 40000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No SR NO 1137 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 89 Issued in 2015 Registration No

Student Bank Account Details

Bank Name DENA BANK Bank Account No 090910039775

Branch Name KALAMB IFSC Code BKDN0470909 MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 3:25:41 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPe1547764M20122015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2012 SSC Seat No e154776 SSC Marks Obtained 47.60

Applicant's Details

Applicant Name VIKAS GORAKHNATH AINKAR Mother's Name VAISHALI

Date of Birth 02-10-1994 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 22-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 62000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 46.31 Pass 2013 - 14 NVM 11 th Arts 2 40.00 Pass 2012 - 13 NVM SSC 1 47.60 Pass

Institution Details

UID Number EID Number

Is Admission after Diploma? No Subject N.A CAP Number 00

College Adm.No 145 Quota Government Quota Joining Date 01-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name GORAKHNATH RAMDAS AINKAR Age 45(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 62000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 119448 District Issuing Thane Taluka Issuing Ulhasnagar Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 2525 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF BARODA Bank Account No 37800100008495

Branch Name NERAL, RAIGAD, MUMBAI IFSC Code BARB0NERALX MICR Code 400012175

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 3:17:26 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1587324M20112015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2011 SSC Seat No E158732 SSC Marks Obtained 41.64

Applicant's Details

Applicant Name SUJATA RAGHUNATH BABARE Mother's Name JANABAI

Date of Birth 30-05-1995 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 20-12-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 35000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 Course not Attended 0 0.00 Pass 2013 - 14 Course not Attended 0 0.00 Pass 2012 - 13 NERAL VIDYA MANDIR NERAL 12th (Arts) 1 43.59 Pass

Institution Details

UID Number 689375696717 EID Number

Is Admission after Diploma? No Subject N.A CAP Number NA

College Adm.No 0352 Quota Government Quota Joining Date 22-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7057828255, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name RAGHUNATH VALKU BABARE Age 45(yrs) Relation with Applicant Mother Profession Housewife

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 35000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel N.A Hostel Admission Date

Hostel Type N.A Is Mess Service Available? No Rent Per Month

Hostel/ Landlord Address N.A

Hostel/Landlord Contact Details N.A

Document Details

Caste Certificate No 1131/2015 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 2065 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125311610000117

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 10:29:32 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1582814M20112015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2011 SSC Seat No E158281 SSC Marks Obtained 63.40

Applicant's Details

Applicant Name MADHUREE VASANT BABRE Mother's Name VANEETA

Date of Birth 17-04-1995 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 20-12-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 62000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NERAL VIDYA MANDIR 12th (Arts) 1 64.77 Pass 2013 - 14 Course not Attended 0 0.00 Pass 2012 - 13 Course not Attended 0 0.00 Pass

Institution Details

UID Number 876577786636 EID Number

Is Admission after Diploma? No Subject N.A CAP Number NA

College Adm.No 0349 Quota Government Quota Joining Date 20-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9765862821, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name VASANT GOMA BABRE Age 45(yrs) Relation with Applicant Mother Profession Housewife

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 62000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel N.A Hostel Admission Date

Hostel Type N.A Is Mess Service Available? No Rent Per Month

Hostel/ Landlord Address N.A

Hostel/Landlord Contact Details N.A

Document Details

Caste Certificate No 463/2008 District Issuing Raigarh Taluka Issuing Panvel Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 3181 Issued in 2015 Registration No

Student Bank Account Details

Bank Name CENTRAL BANK OF INDIA Bank Account No 3903035153

Branch Name KARJAT IFSC Code CBIN0284516 MICR Code 400016119

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 3:14:10 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1763954M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176395 SSC Marks Obtained 53.60

Applicant's Details

Applicant Name SUCHITA RAGHUNATH BADE Mother's Name SHAILA

Date of Birth 30-10-1997 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 25-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 45000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NERAL VIDYAMANDIR JR 12th (Arts) 1 54.92 Pass COLLEGE NERAL 2013 - 14 NERAL VIDYAMANDIR JR 11 th Arts 1 52.00 Pass COLLEGE NERAL 2012 - 13 OMKAR MADHYAMIK VIDYALAYA SSC 1 53.60 Pass SHELU Institution Details

UID Number 297673823832 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 1006 Quota Government Quota Joining Date 18-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9271995540, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Shelu Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name RAGHUNATH NARAYAN BADE Age 45(yrs) Relation with Applicant Father Profession Labor

Parmanent Address Location:- City:- Shelu Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 45000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No SR NO 649/2014 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 3160 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125310110001160

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 3:31:13 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPe1762284M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No e176228 SSC Marks Obtained 50.40

Applicant's Details

Applicant Name YOGITA KISAN BHAGIT Mother's Name JIJABAI

Date of Birth 09-04-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 15-12-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 60000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 65.00 Pass 2013 - 14 NVM 11 th Arts 2 60.00 Pass 2012 - 13 NVM SSC 1 50.40 Pass

Institution Details

UID Number 263925749486 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 00

College Adm.No 262 Quota Government Quota Joining Date 18-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Newali Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name KISAN ANANTA BHAGIT Age 45(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Newali Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 60000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 1034 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 67 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125311610000102

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/24/2016 11:14:51 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1761784M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176178 SSC Marks Obtained 53.00

Applicant's Details

Applicant Name BHUSHAN JANU BHOIR Mother's Name SUNDARA

Date of Birth 17-07-1997 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 07-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 70000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 61.00 Pass 2013 - 14 NVM 11 th Arts 1 60.00 Pass 2012 - 13 NVM SSC 1 53.00 Pass

Institution Details

UID Number 273056092344 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 00

College Adm.No 86 Quota Government Quota Joining Date 18-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9049767175, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Pimploli Bk. Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name JANU pandu BHOIR Age 53(yrs) Relation with Applicant Father Profession Labor

Parmanent Address Location:- City:- Pimploli Bk. Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 70000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 262 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 55 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125311610000093

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 4:08:05 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE5160534M20142015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2014 SSC Seat No E516053 SSC Marks Obtained 0.00

Applicant's Details

Applicant Name REENA DILIP BHOIR Mother's Name SANGITA

Date of Birth 07-06-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 26-11-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 60000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 53.54 Pass 2013 - 14 NVM 11 th Arts 2 50.00 Pass 2012 - 13 NVM SSC 1 35.00 Pass

Institution Details

UID Number 750523436105 EID Number

Is Admission after Diploma? No Subject N.A CAP Number N.A

College Adm.No 1269 Quota Government Quota Joining Date 01-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name DILIP GOPAL BHOIR Age 44(yrs) Relation with Applicant Father Profession Labor

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 60000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 137 District Issuing Raigarh Taluka Issuing Panvel Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 2343 Issued in 2015 Registration No

Student Bank Account Details

Bank Name UNION BANK OF INDIA Bank Account No 320902010028497

Branch Name NERAL IFSC Code UBIN0532096 MICR Code 400026109

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 2:55:16 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1579944M20112015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2011 SSC Seat No E157994 SSC Marks Obtained 69.80

Applicant's Details

Applicant Name SAMEER RAMCHANDRA BHOIR Mother's Name SUSHILA

Date of Birth 20-06-1995 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 09-12-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 40000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 Course not Attended 0 0.00 Pass 2013 - 14 Course not Attended 0 0.00 Pass 2012 - 13 Junior college Neral 12th (Arts) 2 52.50 Pass

Institution Details

UID Number 878605101192 EID Number

Is Admission after Diploma? No Subject N.A CAP Number N.A

College Adm.No 0143 Quota Government Quota Joining Date 18-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7350194598, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Pimploli Bk. Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name RAMCHANDRA PANDU BHOIR Age (yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Pimploli Bk. Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 40000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 89/2013 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 68/2015 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125310110004121

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 3:11:58 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1770644M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E177064 SSC Marks Obtained 50.18

Applicant's Details

Applicant Name SONALI RAMCHANDRA BHOIR Mother's Name SITA

Date of Birth 23-12-1995 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 15-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 30000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 SHRAMAJIVI JANATA 12th (Arts) 1 60.00 Pass VIDYAMANDIR JR COLLEGE POSHIR 2013 - 14 SHRAMAJIVI JANATA 11 th Arts 1 55.00 Pass VIDYAMANDIR JR COLLEGE POSHIR 2012 - 13 SHRAMAJIVI JANATA SSC 1 50.18 Pass VIDYAMANDIR POSHIR Institution Details

UID Number 466492943006 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 1017 Quota Government Quota Joining Date 17-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9764883119, EmailAddress:

Address For Correspondence

Address:- BHOIR NIVAS Location:- KARJAT MURBAD ROAD City:- Kurung Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name RAMCHANDRA VALKU BHOIR Age 45(yrs) Relation with Applicant Father Profession Labor

Parmanent Address BHOIR NIVAS Location:- KARJAT MURBAD ROAD City:- Kurung Pincode:- 410101 Taluka:- Karjat District:- Raigarh Is Father Alive? Yes Annual Income 30000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No sr no 686/2013 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 20 Issued in 2015 Registration No

Student Bank Account Details

Bank Name DENA BANK Bank Account No 090910039806

Branch Name KALAMB IFSC Code BKDN0470909 MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 2:52:08 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1579164M20122015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2012 SSC Seat No E157916 SSC Marks Obtained 65.00

Applicant's Details

Applicant Name SAMADHAN MANOHAR BHOPI Mother's Name MANISHA

Date of Birth 30-10-1996 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 11-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 30000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 70.00 Pass 2013 - 14 NVM 11 th Arts 2 65.00 Pass 2012 - 13 NVM SSC 1 65.00 Pass

Institution Details

UID Number 320030398462 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 00

College Adm.No 319 Quota Government Quota Joining Date 17-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9527165120, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Khandas Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name MANOHAR MALU BHOPI Age 40(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Khandas Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 30000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel N.A Hostel Admission Date

Hostel Type N.A Is Mess Service Available? No Rent Per Month

Hostel/ Landlord Address N.A

Hostel/Landlord Contact Details N.A

Document Details

Caste Certificate No 665 District Issuing Raigarh Taluka Issuing Panvel Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 849 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF MAHARASHTRA Bank Account No 60137338946

Branch Name KASHELE IFSC Code MAHB0000877 MICR Code 1234

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 1:26:20 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1770074M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E177007 SSC Marks Obtained 73.00

Applicant's Details

Applicant Name RESHMA ASHOK DALAVI Mother's Name ARUNA

Date of Birth 07-05-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 04-12-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 35000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 SHRAMAJIVI JANANTA 12th (Arts) 1 83.08 Pass VIDYAMANDIR JR COLLEGE POSHIR 2013 - 14 SHRAMAJIVI JANANTA 11 th Arts 1 78.00 Pass VIDYAMANDIR JR COLLEGE POSHIR 2012 - 13 KES PRAGATI MADHYAMIC SSC 1 73.00 Pass VIDYALAYA KALAMB Institution Details

UID Number 999050471109 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 1025 Quota Government Quota Joining Date 17-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 8149681721, EmailAddress:

Address For Correspondence

Address:- DALAVI NIVAS Location:- City:- Borgaon Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name ASHOK ANANTA DALAVI Age 45(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address DALAVI NIVAS Location:- City:- Borgaon Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 35000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No sr no 395/2013 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A reg no 39/2015 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF BARODA Bank Account No 37800100009015

Branch Name KARJAT BR., MAHARASHTRA IFSC Code BARB0KARJAT MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 3:09:13 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1548094M20122015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2012 SSC Seat No E154809 SSC Marks Obtained 52.80

Applicant's Details

Applicant Name SHRIDHAR RAMESH DALVI Mother's Name RANJANA

Date of Birth 21-06-1996 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 08-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 25000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NERAL VIDYA MANDIR JR 12th (Arts) 1 63.38 Pass COLLEGE NERAL 2013 - 14 DR. DATTA SAMANT SSC 1 52.80 Pass MADHYAMIK VIDYALY VAKAS 2012 - 13 DR. DATTA SAMANT 9th Standard 1 60.00 Pass MADHYAMIK VIDYALY VAKAS Institution Details

UID Number 566789671149 EID Number

Is Admission after Diploma? No Subject N.A CAP Number NA

College Adm.No 0104 Quota Government Quota Joining Date 17-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7350172181, EmailAddress: [email protected]

Address For Correspondence

Address:- Location:- City:- Vakas Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name RAMESH GANU DALVI Age 39(yrs) Relation with Applicant Mother Profession Housewife

Parmanent Address Location:- City:- Vakas Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 25000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel N.A Hostel Admission Date

Hostel Type N.A Is Mess Service Available? No Rent Per Month

Hostel/ Landlord Address N.A

Hostel/Landlord Contact Details N.A

Document Details

Caste Certificate No 454/2014 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 1310 Issued in 2015 Registration No

Student Bank Account Details

Bank Name UNION BANK OF INDIA Bank Account No 320902010028568

Branch Name NERAL IFSC Code UBIN0532096 MICR Code 400026109

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 10:21:56 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPOPE1771331M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No OPE177133 SSC Marks Obtained 59.20

Applicant's Details

Applicant Name karishma Dattatray Dhule Mother's Name Lata

Date of Birth 03-07-1997 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 11-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 65000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 mumbai 12th (Arts) 1 58.62 Pass 2013 - 14 Course not Attended 0 0.00 Pass 2012 - 13 mumbai SSC 1 59.20 Pass

Institution Details

UID Number 775268378508 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 0333 Quota Government Quota Joining Date 14-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9209251418, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name Lata Dattatray Dhule Age 37(yrs) Relation with Applicant Mother Profession Farmer

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? No Annual Income 65000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? Yes

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 502 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing Raigarh Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 3103 Issued in 2015 Registration No

Student Bank Account Details

Bank Name CENTRAL BANK OF INDIA Bank Account No 3479884754

Branch Name KARJAT IFSC Code CBIN0284516 MICR Code 400016119

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 2:41:52 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1771264M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E177126 SSC Marks Obtained 47.64

Applicant's Details

Applicant Name RUPESH RAMDAS DHULE Mother's Name KAVITA

Date of Birth 05-08-1997 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 11-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 35000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 62.00 Pass 2013 - 14 NVM 11 th Arts 2 60.00 Pass 2012 - 13 NVM SSC 1 48.00 Pass

Institution Details

UID Number 360495006449 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 00

College Adm.No 273 Quota Government Quota Joining Date 20-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7030335067, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name RAMDAS GANU DHULE Age 46(yrs) Relation with Applicant Father Profession Labor

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 35000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 715 District Issuing Raigarh Taluka Issuing Panvel Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 1467 Issued in 2015 Registration No

Student Bank Account Details

Bank Name DENA BANK Bank Account No 090910038586

Branch Name KALAMB IFSC Code BKDN0470909 MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 4:21:25 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1763304M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176330 SSC Marks Obtained 54.80

Applicant's Details

Applicant Name SAGAR GAJANAN DURGE Mother's Name KANTABAI

Date of Birth 01-11-1997 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 15-01-2016 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 50000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 neral vidya mandir jr college neral 12th (Arts) 1 56.46 Pass 2013 - 14 neral vidya mandir jr college neral 11 th Arts 1 59.00 Pass 2012 - 13 datta samant madhymic vidyalaya SSC 1 54.80 Pass wakas Institution Details

UID Number 309919795602 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 0

College Adm.No 1035 Quota Government Quota Joining Date 10-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 8446708645, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Newali Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name GAJANAN WALAKU DURGE Age (yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Newali Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 50000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No Sr. No. 350/2013 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A Sr. No. 3607/2015 Issued in 2015 Registration No

Student Bank Account Details

Bank Name UNION BANK OF INDIA Bank Account No 320902120000125

Branch Name NERAL IFSC Code UBIN0532096 MICR Code 400026109

Document Attached Caste Certificate Issued by Competant Officer Income Proof Income Certificate Issued by Competant Authority I-card Size Photo SSC Mark Sheet UID document xerox Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/24/2016 10:24:24 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1765324M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176532 SSC Marks Obtained 67.82

Applicant's Details

Applicant Name ANKITA SHANKAR GOMARE Mother's Name SUREKHA

Date of Birth 22-11-1997 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 18-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 30000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NERAL VIDYA MANDIR AND 12th (Arts) 1 66.31 Pass JUNIOR COLLEGE,NERAL 2013 - 14 NERAL VIDYA MANDIR AND 11 th Arts 1 60.76 Pass JUNIOR COLLEGE,NERAL 2012 - 13 NERAL VIDYA MANDIR AND SSC 1 67.82 Pass JUNIOR COLLEGE,NERAL Institution Details

UID Number 724064514877 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 0174 Quota Government Quota Joining Date 20-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9637077991, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Kolhare Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name SHANKAR GANPAT GOMARE Age 40(yrs) Relation with Applicant Father Profession Labor

Parmanent Address Location:- City:- Kolhare Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 30000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 503/2015 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 2500 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF BARODA Bank Account No 37800100008907

Branch Name NERAL, RAIGAD, MUMBAI IFSC Code BARB0NERALX MICR Code 400012175

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 10:50:55 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1588094M20112015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2011 SSC Seat No E158809 SSC Marks Obtained 50.20

Applicant's Details

Applicant Name NITIN NARAYAN HABALE Mother's Name KALPANA

Date of Birth 08-06-1996 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 28-11-2015 Marital Status Yes Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 35000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 Junior College of Arts, Poshir 12th (Arts) 2 42.15 Pass 2013 - 14 Course not Attended 0 0.00 Pass 2012 - 13 Course not Attended 0 0.00 Pass

Institution Details

UID Number 870020793084 EID Number

Is Admission after Diploma? No Subject N.A CAP Number N.A

College Adm.No 0122 Quota Government Quota Joining Date 18-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 8805040522, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Poshir Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name NARAYAN VALKU HABALE Age 47(yrs) Relation with Applicant Father Profession Others

Parmanent Address Location:- City:- Poshir Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 35000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 249/2012 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 1347 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125311610000130

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 3:01:49 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1770224M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E177022 SSC Marks Obtained 59.27

Applicant's Details

Applicant Name SARIKA TUKARAM HABALE Mother's Name SHANTA

Date of Birth 02-01-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 25-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 45000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 SHRAM JIVI JANTA JR COLLEGE 12th (Arts) 1 62.46 Pass POSHIR 2013 - 14 SHRAM JIVI JANTA JR COLLEGE 11 th Arts 1 58.00 Pass POSHIR 2012 - 13 SHRAM JIVI JANTA VIDYALAY SSC 1 59.27 Pass POSHIR Institution Details

UID Number 528285636218 EID Number

Is Admission after Diploma? No Subject N.A CAP Number NA

College Adm.No 0168 Quota Government Quota Joining Date 20-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7304096146, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Poshir Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name TUKARAM GOVIND HABALE Age 54(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Poshir Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 45000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel N.A Hostel Admission Date

Hostel Type N.A Is Mess Service Available? No Rent Per Month

Hostel/ Landlord Address N.A

Hostel/Landlord Contact Details N.A

Document Details

Caste Certificate No 1139/2014 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A RN. 2483 Issued in 2015 Registration No

Student Bank Account Details

Bank Name CENTRAL BANK OF INDIA Bank Account No 3479629136

Branch Name KARJAT IFSC Code CBIN0284516 MICR Code 400016119

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 2:49:00 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1581454M20122015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2012 SSC Seat No E158145 SSC Marks Obtained 62.60

Applicant's Details

Applicant Name SAGAR PANDHARINATH HILAL Mother's Name SHARADA

Date of Birth 15-11-1994 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 09-01-2016 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 70000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 M B RAUTH KASHELE 12th (Arts) 1 52.77 Pass 2013 - 14 Course not Attended 0 0.00 Pass 2012 - 13 Course not Attended 0 0.00 Pass

Institution Details

UID Number 991147805842 EID Number

Is Admission after Diploma? No Subject N.A CAP Number NA

College Adm.No 0172 Quota Government Quota Joining Date 20-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7798566525, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Antrat T. Need Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name PANDHARINATH RAVAJI HILAL Age 49(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Antrat T. Need Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 70000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 123 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 288 Issued in 2015 Registration No

Student Bank Account Details

Bank Name UNION BANK OF INDIA Bank Account No 320902010028832

Branch Name NERAL IFSC Code UBIN0532096 MICR Code 400026109

Document Attached Caste Certificate Issued by Competant Officer Income Proof Income Certificate Issued by Competant Authority I-card Size Photo SSC Mark Sheet UID document xerox Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/24/2016 1:09:01 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1765934M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176593 SSC Marks Obtained 61.40

Applicant's Details

Applicant Name DARSHANA ANANTA JOGALE Mother's Name ANITA

Date of Birth 07-12-1997 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 07-01-2016 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 50000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 63.23 Pass 2013 - 14 NVM 11 th Arts 2 70.00 Pass 2012 - 13 NVM SSC 1 61.40 Pass

Institution Details

UID Number 551864595192 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 00

College Adm.No 213 Quota Government Quota Joining Date 18-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9881858528, EmailAddress: [email protected]

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name ANANTA NARYANA JOGALE Age 54(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 50000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel N.A Hostel Admission Date

Hostel Type N.A Is Mess Service Available? No Rent Per Month

Hostel/ Landlord Address N.A

Hostel/Landlord Contact Details N.A

Document Details

Caste Certificate No 638 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 228 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125311610000092

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/26/2016 11:13:58 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1761174M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176117 SSC Marks Obtained 51.40

Applicant's Details

Applicant Name HEMLATA PANDHARINATH KADAM Mother's Name PRIYA

Date of Birth 09-02-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 23-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 40000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM JR COLLEGE NERAL 12th (Arts) 1 60.00 Pass 2013 - 14 NVM JR COLLEGE NERAL 11 th Arts 1 54.00 Pass 2012 - 13 KONDIRAM SHENDE SSC 1 51.00 Pass MHADHYAMIK VIDYLAY BHADWAL Institution Details

UID Number 582282747516 EID Number

Is Admission after Diploma? No Subject N.A CAP Number na

College Adm.No na Quota Government Quota Joining Date 14-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9527190239, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Bhadwal Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name PANDHARINATH KRUSHNA KADAM Age 48(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Bhadwal Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 40000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel N.A Hostel Admission Date

Hostel Type N.A Is Mess Service Available? No Rent Per Month

Hostel/ Landlord Address N.A

Hostel/Landlord Contact Details N.A

Document Details

Caste Certificate No 07/2013 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A RN 621/2015 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF BARODA Bank Account No 50080100000151

Branch Name KARJAT BR., MAHARASHTRA IFSC Code BARB0KARJAT MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/24/2016 4:54:56 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1547074M20122015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2012 SSC Seat No E154707 SSC Marks Obtained 58.20

Applicant's Details

Applicant Name GEETA NANA KALAN Mother's Name PADMA

Date of Birth 20-05-1997 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 01-11-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 40000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 77.85 Pass 2013 - 14 NVM 11 th Arts 2 70.00 Pass 2012 - 13 NVM SSC 1 58.20 Pass

Institution Details

UID Number 734822512624 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 00

College Adm.No 197 Quota Government Quota Joining Date 23-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name NANA SHRIPAT KALAN Age 52(yrs) Relation with Applicant Father Profession Labor

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 40000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 1109 District Issuing Raigarh Taluka Issuing Panvel Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 173 Issued in 2015 Registration No

Student Bank Account Details

Bank Name DENA BANK Bank Account No 090910039805

Branch Name KALAMB IFSC Code BKDN0470909 MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 3:20:39 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPe1764244M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No e176424 SSC Marks Obtained 48.00

Applicant's Details

Applicant Name TRUPTI SHARAD KALEKAR Mother's Name SHARDA

Date of Birth 21-02-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 28-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 25000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 60.00 Pass 2013 - 14 NVM 11 th Arts 2 55.00 Pass 2012 - 13 NVM SSC 1 48.00 Pass

Institution Details

UID Number 579029682390 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 000

College Adm.No 297 Quota Government Quota Joining Date 18-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name SHARAD AMBO KALEKAR Age 45(yrs) Relation with Applicant Father Profession Labor

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 25000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 879 District Issuing Raigarh Taluka Issuing Panvel Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 150 Issued in 2015 Registration No

Student Bank Account Details

Bank Name UNION BANK OF INDIA Bank Account No 320902010018789

Branch Name NERAL IFSC Code UBIN0532096 MICR Code 400026109

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 2:38:23 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPe1770954M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No e177095 SSC Marks Obtained 65.27

Applicant's Details

Applicant Name RUPALI KASHINATH KAMBARI Mother's Name KAVITA

Date of Birth 11-08-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 28-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 50000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 70.00 Pass 2013 - 14 NVM 11 th Arts 2 65.00 Pass 2012 - 13 NVM SSC 1 65.27 Pass

Institution Details

UID Number 559950982625 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 000

College Adm.No 180 Quota Government Quota Joining Date 20-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name KASHINATH JANU KAMBARI Age 40(yrs) Relation with Applicant Father Profession Labor

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 50000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 748 District Issuing Raigarh Taluka Issuing Panvel Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 2383 Issued in 2015 Registration No

Student Bank Account Details

Bank Name UNION BANK OF INDIA Bank Account No 320902010028647

Branch Name NERAL IFSC Code UBIN0532096 MICR Code 400026109

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 11:03:31 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1775194M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E177519 SSC Marks Obtained 49.00

Applicant's Details

Applicant Name PRAJAKTA MURALIDHAR KARALE Mother's Name SANGITA

Date of Birth 30-03-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 23-10-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 55000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 54.00 Pass 2013 - 14 NVM 11 th Arts 2 50.00 Pass 2012 - 13 NVM SSC 1 49.00 Pass

Institution Details

UID Number 705152971917 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 00

College Adm.No 313 Quota Government Quota Joining Date 07-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9209109432, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name MURALIDHAR MANGAL KARALE Age 49(yrs) Relation with Applicant Father Profession Service

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 55000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 515 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 3660 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF BARODA Bank Account No 37800100008729

Branch Name KARJAT BR., MAHARASHTRA IFSC Code BARB0KARJAT MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/13/2016 3:11:09 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPOPE1535861M20102015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2010 SSC Seat No OPE153586 SSC Marks Obtained 86.18

Applicant's Details

Applicant Name ASHWINI DIGMBAR MALI Mother's Name ASHA

Date of Birth 17-02-1994 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 06-11-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 40000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 Course not Attended 0 0.00 Pass 2013 - 14 Course not Attended 0 0.00 Pass 2012 - 13 Course not Attended 0 0.00 Pass

Institution Details

UID Number EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 0184 Quota Government Quota Joining Date 20-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9075473692, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name DIGMBAR Krushna MALI Age 50(yrs) Relation with Applicant Father Profession Service/ Business

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 40000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? Yes

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 865 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 68 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125311610000158

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 10:38:22 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPe1761674M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No e176167 SSC Marks Obtained 43.82

Applicant's Details

Applicant Name MAHESH VASANT MALI Mother's Name JANABAI

Date of Birth 29-10-1995 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 20-10-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 50000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 54.00 Pass 2013 - 14 NVM 11 th Arts 2 50.00 Pass 2012 - 13 NVM SSC 1 43.82 Pass

Institution Details

UID Number 865946842845 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 00

College Adm.No 125 Quota Government Quota Joining Date 11-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name VASANT TUKARAM MALI Age 45(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 50000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 274 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 87 Issued in 2015 Registration No

Student Bank Account Details

Bank Name CENTRAL BANK OF INDIA Bank Account No 3483737316

Branch Name KARJAT IFSC Code CBIN0284516 MICR Code 400016119

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 10:41:50 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPe1762324M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No e176232 SSC Marks Obtained 55.80

Applicant's Details

Applicant Name NIKITA UDAY MASANE Mother's Name VAISHALI

Date of Birth 15-05-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 23-10-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 50000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 52.00 Pass 2013 - 14 NVM 11 th Arts 2 50.00 Pass 2012 - 13 NVM SSC 1 55.80 Pass

Institution Details

UID Number 520234949997 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 00

College Adm.No 101 Quota Government Quota Joining Date 11-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name UDAY RAMCHANDRA MASANE Age 45(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 50000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 7990/2015 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 749 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF BARODA Bank Account No 37800100008923

Branch Name NERAL, RAIGAD, MUMBAI IFSC Code BARB0NERALX MICR Code 400012175

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 4:30:23 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1776944M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E177694 SSC Marks Obtained 49.80

Applicant's Details

Applicant Name TEJSHREE RAMESH MASNE Mother's Name RESHMA

Date of Birth 19-04-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 18-11-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 40000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NERAL VIDYA MANDIR JR 12th (Arts) 1 52.77 Pass COLLEGE 2013 - 14 NERAL VIDYA MANDIR JR 11 th Arts 1 52.15 Pass COLLEGE 2012 - 13 OMKAR MADHYAMIC VIDYALAY SSC 1 49.80 Pass SHELU Institution Details

UID Number EID Number

Is Admission after Diploma? No Subject N.A CAP Number 0

College Adm.No 120 Quota Government Quota Joining Date 18-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7875511845, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Shelu Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name RAMESH PANDURANG MASNE Age 49(yrs) Relation with Applicant Father Profession Labor

Parmanent Address Location:- City:- Shelu Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 40000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No SR.NO.936/2013 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A SR.NO.179/2015 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125311610000115

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 10:16:12 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPe1775884M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No e177588 SSC Marks Obtained 49.60

Applicant's Details

Applicant Name KANCHAN HARISHCHANDR MINMINE Mother's Name ARCHANA A Date of Birth 28-12-1996 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 03-11-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 45000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 56.62 Pass 2013 - 14 NVM 11 th Arts 2 56.61 Pass 2012 - 13 NVM SSC 1 49.60 Pass

Institution Details

UID Number 831192079350 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 00

College Adm.No 169 Quota Government Quota Joining Date 11-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name HARISHCHANDR TATU MINMINE Age 45(yrs) A Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 45000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 328 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 2402 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 122810110003219

Branch Name KADAV IFSC Code BKID0001228 MICR Code 402013506

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/26/2016 11:10:20 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPe1765624M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No e176562 SSC Marks Obtained 40.40

Applicant's Details

Applicant Name HEMANT DATTATRAY MISAL Mother's Name SUNITA

Date of Birth 16-08-1998 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 28-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 45000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 42.00 Pass 2013 - 14 NVM 11 th Arts 2 41.00 Pass 2012 - 13 NVM SSC 1 40.40 Pass

Institution Details

UID Number 551425100285 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 000

College Adm.No 327 Quota Government Quota Joining Date 18-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name DATTATRAY SHIVRAM MISAL Age 42(yrs) Relation with Applicant Father Profession Labor

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 45000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 06/2013 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 44 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125311610000111

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 2:44:11 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1770774M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E177077 SSC Marks Obtained 42.00

Applicant's Details

Applicant Name SACHIN MANGAL MORE Mother's Name MANDA

Date of Birth 07-06-1997 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 29-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 32000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 SHRAMAJIVI JANATA 12th (Arts) 1 57.85 Pass VIDYAMANDIR JR COLLEGE POSHIR 2013 - 14 SHRAMAJIVI JANATA 11 th Arts 1 45.00 Pass VIDYAMANDIR JR COLLEGE POSHIR 2012 - 13 KES PRAGATI MADHYAMIK SSC 1 42.00 Pass VIDYALAYA KALAMB Institution Details

UID Number 833884138890 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 1054 Quota Government Quota Joining Date 23-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 8805887431, EmailAddress:

Address For Correspondence

Address:- MORE NIVAS Location:- KALAMB MURBAD ROAD City:- Kalamb Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name MANGAL BABU MORE Age 45(yrs) Relation with Applicant Father Profession Unemployed

Parmanent Address MORE NIVAS Location:- KALAMB MURBAD ROAD City:- Kalamb Pincode:- 410101 Taluka:- Karjat District:- Raigarh Is Father Alive? Yes Annual Income 32000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No sr no 526/2015 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A reg no 3289 Issued in 2015 Registration No

Student Bank Account Details

Bank Name DENA BANK Bank Account No 090910039819

Branch Name KALAMB IFSC Code BKDN0470909 MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 3:22:50 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1768864M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176886 SSC Marks Obtained 45.60

Applicant's Details

Applicant Name UMESH GANPAT MORE Mother's Name SHARADA

Date of Birth 09-01-1998 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 23-10-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 30000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 SHRAMAJIVI JANATA 12th (Arts) 1 60.31 Pass VIDYAMANDIR JR COLLEGE POSHIR 2013 - 14 SHRAMAJIVI JANATA 11 th Arts 1 50.00 Pass VIDYAMANDIR JR COLLEGE POSHIR 2012 - 13 KES PRAGATI MADHYAMIK SSC 1 45.60 Pass VIDYALAYA KALAMB Institution Details

UID Number 570325757239 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 1075 Quota Government Quota Joining Date 23-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9130318596, EmailAddress: [email protected]

Address For Correspondence

Address:- more nivas Location:- City:- Kalamb Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name GANPAT BABU MORE Age 56(yrs) Relation with Applicant Father Profession Unemployed

Parmanent Address more nivas Location:- City:- Kalamb Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 30000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No SR NO 451/2015 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A REG NO 162 Issued in 2015 Registration No

Student Bank Account Details

Bank Name DENA BANK Bank Account No 090910039906

Branch Name KALAMB IFSC Code BKDN0470909 MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 3:06:19 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1554614M20122015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2012 SSC Seat No E155461 SSC Marks Obtained 40.36

Applicant's Details

Applicant Name SHARAD JANARDAN MORGE Mother's Name KANTA

Date of Birth 03-12-1995 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 10-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 40000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 SHRAMAJIVI JANATA 12th (Arts) 1 54.46 Pass VIDYAMANDIR JR COLLEGE POSHIR 2013 - 14 SHRAMAJIVI JANATA 11 th Arts 2 49.00 Pass VIDYAMANDIR JR COLLEGE POSHIR 2012 - 13 KES PRAGATI MADHYAMIK SSC 1 40.36 Pass VIDYALAYA KALAMB Institution Details

UID Number 937527209812 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 1076 Quota Government Quota Joining Date 20-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 8237185541, EmailAddress: [email protected]

Address For Correspondence

Address:- MORGHE NIVAS Location:- KARJAT MURBAD ROAD City:- Kalamb Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name JANARDAN BALU MORGE Age 55(yrs) Relation with Applicant Father Profession Labor

Parmanent Address MORGHE NIVAS Location:- KARJAT MURBAD ROAD City:- Kalamb Pincode:- 410101 Taluka:- Karjat District:- Raigarh Is Father Alive? Yes Annual Income 40000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No SR NO 521/2012 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A REG NO 1303 Issued in 2015 Registration No

Student Bank Account Details

Bank Name DENA BANK Bank Account No 090910039804

Branch Name KALAMB IFSC Code BKDN0470909 MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 12:33:36 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1769354M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176935 SSC Marks Obtained 67.00

Applicant's Details

Applicant Name PRIYANKA MAHADU MURBE Mother's Name ANITA

Date of Birth 01-09-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 23-10-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 35000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 Shramjivi Janta Jr.college,Poshir 12th Commerce 1 72.00 Pass Tal.Karajat Dist.Raigad 2013 - 14 SJVMP 11 th Arts 1 66.00 Pass 2012 - 13 SJVMP SSC 1 67.00 Pass

Institution Details

UID Number 998305309788 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 0000

College Adm.No 170 Quota Government Quota Joining Date 20-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9823658015, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Deopada Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name MAHADU NAMDEV MURBE Age 45(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Deopada Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 35000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 687 District Issuing Raigarh Taluka Issuing Panvel Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 94 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125310510000195

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 1:35:57 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1771104M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E177110 SSC Marks Obtained 49.20

Applicant's Details

Applicant Name RINA RAMESH NAIK Mother's Name VAISHALI

Date of Birth 10-05-1997 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 10-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 40000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NERAL VIDYAMANDIR JR 12th (Arts) 1 49.69 Pass COLLEGE NERAL 2013 - 14 NERAL VIDYAMANDIR JR 11 th Arts 1 50.00 Pass COLLEGE NERAL 2012 - 13 KES PRAGATI MADHYAMIK SSC 1 49.20 Pass VIDYALAYA KALAMB Institution Details

UID Number 572008120718 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 1078 Quota Government Quota Joining Date 11-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9271834427, EmailAddress:

Address For Correspondence

Address:- NAIK NIVAS Location:- KARJAT MURBAD ROAD City:- Kalamb Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name RAMESH DEHU NAIK Age 40(yrs) Relation with Applicant Father Profession Labor

Parmanent Address NAIK NIVAS Location:- KARJAT MURBAD ROAD City:- Kalamb Pincode:- 410101 Taluka:- Karjat District:- Raigarh Is Father Alive? Yes Annual Income 40000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No SR NO 803/2015 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A REG NO 803 Issued in 2015 Registration No

Student Bank Account Details

Bank Name DENA BANK Bank Account No 090910039678

Branch Name KALAMB IFSC Code BKDN0470909 MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 10:36:14 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1770824M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E177082 SSC Marks Obtained 39.40

Applicant's Details

Applicant Name MAHENDRA SHANTARAM PATIL Mother's Name CHANDRABAI

Date of Birth 13-03-1997 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 12-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 47000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 SHRAMAJIVI JANATA 12th (Arts) 1 61.00 Pass VIDYAMANDIR JR COLLEGE POSHIR 2013 - 14 SHRAMAJIVI JANATA 11 th Arts 1 47.38 Pass VIDYAMANDIR JR COLLEGE POSHIR 2012 - 13 KES PRAGATI MADHYAMIK SSC 1 39.40 Pass VIDYALAYA KALAMB Institution Details

UID Number 787063722587 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 1089 Quota Government Quota Joining Date 15-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7276188118, EmailAddress: [email protected]

Address For Correspondence

Address:- PATIL NIVAS Location:- KARJAT MURBAD ROAD City:- Borgaon Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name SHANTARAM ANNA PATIL Age 47(yrs) Relation with Applicant Father Profession Labor

Parmanent Address PATIL NIVAS Location:- KARJAT MURBAD ROAD City:- Borgaon Pincode:- 410101 Taluka:- Karjat District:- Raigarh Is Father Alive? Yes Annual Income 47000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No sr no 388/2013 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A reg no 155 Issued in 2015 Registration No

Student Bank Account Details

Bank Name DENA BANK Bank Account No 090910039821

Branch Name KALAMB IFSC Code BKDN0470909 MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 11:06:34 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1763164M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176316 SSC Marks Obtained 43.00

Applicant's Details

Applicant Name PRAMOD SADASHIV PATIL Mother's Name SUNITA

Date of Birth 17-05-1997 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 23-10-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 55000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 48.00 Pass 2013 - 14 NVM 11 th Arts 2 45.00 Pass 2012 - 13 NVM SSC 1 43.00 Pass

Institution Details

UID Number 963006788016 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 000

College Adm.No 333 Quota Government Quota Joining Date 20-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name SADASHIV NAMDEV PATIL Age 47(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 55000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 183 District Issuing Raigarh Taluka Issuing Panvel Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 3631 Issued in 2015 Registration No

Student Bank Account Details

Bank Name CENTRAL BANK OF INDIA Bank Account No 3487698430

Branch Name KARJAT IFSC Code CBIN0284516 MICR Code 400016119

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 1:14:34 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1769364M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176936 SSC Marks Obtained 52.80

Applicant's Details

Applicant Name PRIYANKA PANDIT PATIL Mother's Name KALPANA

Date of Birth 07-05-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 11-10-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 36000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM JR COLLEGE NERAL 12th (Arts) 1 45.00 Pass 2013 - 14 NVM JR COLLEGE NERAL 11 th Arts 1 50.00 Pass 2012 - 13 JANATA MHAVIDYALAY POSHIR SSC 1 52.00 Pass

Institution Details

UID Number 695154934241 EID Number

Is Admission after Diploma? No Subject N.A CAP Number NA

College Adm.No 0133 Quota Government Quota Joining Date 18-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7040958594, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Maniwali Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name PANDIT NARAYAN PATIL Age 50(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Maniwali Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 36000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel N.A Hostel Admission Date

Hostel Type N.A Is Mess Service Available? No Rent Per Month

Hostel/ Landlord Address N.A

Hostel/Landlord Contact Details N.A

Document Details

Caste Certificate No 694/2013 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A RN 42/2015 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF BARODA Bank Account No 37800100008774

Branch Name KARJAT BR., MAHARASHTRA IFSC Code BARB0KARJAT MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 1:17:59 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1246704M20082015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2008 SSC Seat No E124670 SSC Marks Obtained 51.23

Applicant's Details

Applicant Name RAVINDRA SHANTARAM PATIL Mother's Name SHEVANTI

Date of Birth 08-07-1990 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 06-11-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 46000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 Course not Attended 0 0.00 Pass 2013 - 14 Course not Attended 0 0.00 Pass 2012 - 13 Course not Attended 0 0.00 Pass

Institution Details

UID Number 302210240555 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 510 Quota Government Quota Joining Date 15-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7875991561, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Borgaon Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name SHANTARAM ANNA PATIL Age (yrs) Relation with Applicant Father Profession Unemployed

Parmanent Address Location:- City:- Borgaon Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 46000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? Yes

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 1305 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 65 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF BARODA Bank Account No 37800100008345

Branch Name KARJAT BR., MAHARASHTRA IFSC Code BARB0KARJAT MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 3:04:14 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPD0929797M19962015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 1996 SSC Seat No D092979 SSC Marks Obtained 46.40

Applicant's Details

Applicant Name SARLA RAMDAS PATIL Mother's Name ANUSAYA

Date of Birth 14-04-1979 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 24-09-2015 Marital Status Yes Caste Category Other Backward Class

Caste Kunbi (83) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 48000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NA Course not Attended 0 0.00 ATKT 2013 - 14 NA Course not Attended 0 0.00 ATKT 2012 - 13 NA Course not Attended 0 0.00 ATKT

Institution Details

UID Number 805832266905 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 0

College Adm.No 4867 Quota Government Quota Joining Date 19-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9881185467, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name RAMDAS DHANA PATIL Age 55(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 48000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel N.A Hostel Admission Date

Hostel Type N.A Is Mess Service Available? No Rent Per Month

Hostel/ Landlord Address N.A

Hostel/Landlord Contact Details N.A

Document Details

Caste Certificate No N.A District Issuing Taluka Issuing N.A Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A N.A Issued in N.A Registration No

Student Bank Account Details

Bank Name CENTRAL BANK OF INDIA Bank Account No 3489424738

Branch Name KARJAT IFSC Code CBIN0284516 MICR Code 400016119

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/24/2016 10:51:18 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1765614M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176561 SSC Marks Obtained 63.40

Applicant's Details

Applicant Name ASHWINI GOVIND RANE Mother's Name SUNANDA

Date of Birth 08-10-1996 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 26-10-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 95000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 64.00 Pass 2013 - 14 NVM 11 th Arts 2 60.00 Pass 2012 - 13 NVM SSC 1 63.40 Pass

Institution Details

UID Number 850698683999 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 000

College Adm.No 90 Quota Government Quota Joining Date 17-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name GOVIND JANU RANE Age 52(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 95000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 332 District Issuing Raigarh Taluka Issuing Panvel Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 18 Issued in 2015 Registration No

Student Bank Account Details

Bank Name UNION BANK OF INDIA Bank Account No 320902010028446

Branch Name NERAL IFSC Code UBIN0532096 MICR Code 400026109

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/24/2016 1:36:21 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1554854M20122015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2012 SSC Seat No E155485 SSC Marks Obtained 53.20

Applicant's Details

Applicant Name DARSHANA SITARAM RANE Mother's Name NIRMALA

Date of Birth 21-10-1996 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 12-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 24000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 Course not Attended 0 0.00 Pass 2013 - 14 SHRAMJIVI JANTA VIDYA 12th (Arts) 1 61.85 Pass MANDIR 2012 - 13 SHRAMJIVI JANTA VIDYA 11 th Arts 1 53.84 Pass MANDIR Institution Details

UID Number 276476520611 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 4828 Quota Government Quota Joining Date 18-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 8983672264, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Poshir Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name SITARAM ANANTA RANE Age 65(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Poshir Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 24000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 436/2015 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 1921 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125310110002029

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 4:00:31 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1769774M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176977 SSC Marks Obtained 37.80

Applicant's Details

Applicant Name PARESH DILIP RANE Mother's Name VIJAYA

Date of Birth 04-07-1997 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 07-11-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 30000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 n.v.m.jr.college 12th (Arts) 2 53.23 Pass 2013 - 14 n.v.m.jr.college 11 th Arts 1 40.00 Pass 2012 - 13 n.v.m.school neral SSC 1 37.80 Pass

Institution Details

UID Number 412416971101 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 1

College Adm.No 0825 Quota Government Quota Joining Date 25-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9765277306, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name DILIP lashman RANE Age 50(yrs) Relation with Applicant Father Profession Unemployed

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 30000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? Yes

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 974 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 1430 Issued in 2015 Registration No

Student Bank Account Details

Bank Name DENA BANK Bank Account No 021110025450

Branch Name KALAMB IFSC Code BKDN0470909 MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 11:11:10 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1770564M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E177056 SSC Marks Obtained 73.45

Applicant's Details

Applicant Name PRATIKSHA SANTOSH RANE Mother's Name VANDANA

Date of Birth 14-06-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 21-10-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 30000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 Shramjivi Janta Jr.college,Poshir 12th Commerce 1 78.00 Pass Tal.Karajat Dist.Raigad 2013 - 14 SJVMP SSC 1 73.00 Pass 2012 - 13 SJVMP 9th Standard 1 73.00 Pass

Institution Details

UID Number 318711496870 EID Number

Is Admission after Diploma? No Subject N.A CAP Number N.A

College Adm.No 1103 Quota Government Quota Joining Date 20-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 8308630721, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Poshir Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name VANDANA SANTOSH RANE Age 40(yrs) Relation with Applicant Mother Profession Others

Parmanent Address Location:- City:- Poshir Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? No Annual Income 30000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 1047 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 70/2015 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125311610000047

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 10:48:05 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPe1769094M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No e176909 SSC Marks Obtained 40.18

Applicant's Details

Applicant Name NITA MANGAL SHEKTE Mother's Name HIRABAI

Date of Birth 07-04-1995 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 23-10-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 35000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 46.46 Pass 2013 - 14 NVM 11 th Arts 2 45.00 Pass 2012 - 13 NVM SSC 1 40.18 Pass

Institution Details

UID Number 375731863174 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 00

College Adm.No 175 Quota Government Quota Joining Date 20-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name MANGAL posu SHEKTE Age 42(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 35000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 255 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 826 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125311610000116

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 3:46:46 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1764284M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176428 SSC Marks Obtained 43.80

Applicant's Details

Applicant Name KEVAL PUNDLIK SHINARE Mother's Name URMILA

Date of Birth 24-07-1998 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 10-12-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 75000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NERAL VIDYA MANDIR NERAL 12th (Arts) 1 43.54 Pass JR.COLLGES OF NERAL 2013 - 14 NERAL VIDYA MANDIR NERAL 11 th Arts 1 45.23 Pass JR.COLLGES OF NERAL 2012 - 13 NERAL VIDYA MANDIR NERAL SSC 1 43.80 Pass

Institution Details

UID Number 459386325585 EID Number

Is Admission after Diploma? No Subject N.A CAP Number NA

College Adm.No 176 Quota Government Quota Joining Date 20-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9260534876, EmailAddress:

Address For Correspondence

Address:- Location:- NERAL-MAMDAPUR City:- Mamdapur Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name PUNDLIK BANDU SHINARE Age 52(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- NERAL-MAMDAPUR City:- Mamdapur Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 75000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 852 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 1457 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF BARODA Bank Account No 37800100008790

Branch Name KARJAT BR., MAHARASHTRA IFSC Code BARB0KARJAT MICR Code 11111

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 10:59:10 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1771074M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E177107 SSC Marks Obtained 46.73

Applicant's Details

Applicant Name PRACHI HANUMAN SHINGATE Mother's Name SANGITA

Date of Birth 11-04-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 15-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 45000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 SHRAMJIVI JANTA 12th (Arts) 1 55.08 Pass VIDYAMANDIR JR COLLEGE POSHIR 2013 - 14 SHRAMJIVI JANTA 11 th Arts 1 53.53 Pass VIDYAMANDIR JR COLLEGE POSHIR 2012 - 13 SHRAMJIVI JANTA SSC 1 46.73 Pass VIDYAMANDIR POSHIR Institution Details

UID Number 792171956350 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 0

College Adm.No 0169 Quota Government Quota Joining Date 20-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 8976081979, EmailAddress:

Address For Correspondence

Address:- Location:- NERAL KALAMB ROAD City:- Poshir Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name HANUMAN KESHAV SHINGATE Age 45(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- NERAL KALAMB ROAD City:- Poshir Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 45000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? Yes

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 1050/2014 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 1321 Issued in 2015 Registration No

Student Bank Account Details

Bank Name CENTRAL BANK OF INDIA Bank Account No 3480287936

Branch Name KARJAT IFSC Code CBIN0284516 MICR Code 400016119

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/24/2016 1:40:48 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1762054M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E176205 SSC Marks Obtained 60.00

Applicant's Details

Applicant Name DIGAMBAR NAGO SONAWALE Mother's Name VANDNA

Date of Birth 01-01-1996 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 14-12-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 65000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NERAL VIDYA MANDIR JR 12th (Arts) 1 60.62 Pass COLLEGE 2013 - 14 NERAL VIDYA MANDIR JR 11 th Arts 1 48.00 Pass COLLEGE 2012 - 13 NERAL VIDYABHAVAN SSC 1 60.00 Pass DHAMOTE Institution Details

UID Number 389052814134 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 0

College Adm.No 1117 Quota Government Quota Joining Date 23-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9028452371, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Pimploli Bk. Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name NAGO PADU SONAWALE Age (yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Pimploli Bk. Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 65000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No SR.NO 5112/2011 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A SR.NO.3652/2015 Issued in 2015 Registration No

Student Bank Account Details

Bank Name UNION BANK OF INDIA Bank Account No 320902010028595

Branch Name NERAL IFSC Code UBIN0532096 MICR Code 400026109

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/26/2016 11:06:22 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPe0832874M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No e083287 SSC Marks Obtained 47.82

Applicant's Details

Applicant Name HARSHALA SADANAND TEMBHE Mother's Name TARA

Date of Birth 11-02-1998 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 23-10-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 40000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 52.00 Pass 2013 - 14 NVM 11 th Arts 2 50.00 Pass 2012 - 13 NVM SSC 1 48.00 Pass

Institution Details

UID Number 768800153548 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 000

College Adm.No 304 Quota Government Quota Joining Date 18-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name SADANAND GANPAT TEMBHE Age 51(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 40000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 114 District Issuing Thane Taluka Issuing Ambarnath Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 534 Issued in 2015 Registration No

Student Bank Account Details

Bank Name UNION BANK OF INDIA Bank Account No 320902010028620

Branch Name NERAL IFSC Code UBIN0532096 MICR Code 400026109

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 2:58:58 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1547494M20122015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2012 SSC Seat No E154749 SSC Marks Obtained 47.40

Applicant's Details

Applicant Name SANGRAM BABAN THOMBARE Mother's Name CANDRA

Date of Birth 04-12-1996 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 11-01-2016 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 49000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NERAL VIDYA MANDIR NERAL 12th (Arts) 1 64.15 Pass 2013 - 14 NERAL VIDYA MANDIR NERAL 11 th Arts 1 55.05 Pass 2012 - 13 DR. D S. MADHEMIK VIDYALAY SSC 1 47.40 Pass WAKAS Institution Details

UID Number 823029696632 EID Number

Is Admission after Diploma? No Subject N.A CAP Number NA

College Adm.No 650 Quota Government Quota Joining Date 05-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9604575604, EmailAddress:

Address For Correspondence

Address:- Location:- NERAL-WAKAS City:- Vakas Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name BABAN GOVIND THOMBARE Age 45(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- NERAL-WAKAS City:- Vakas Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 49000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 136 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 1816 Issued in 2015 Registration No

Student Bank Account Details

Bank Name STATE BANK OF INDIA Bank Account No 34906048090

Branch Name KARJAT RAIGAD IFSC Code SBIN0012869 MICR Code 522002206

Document Attached Caste Certificate Issued by Competant Officer Income Proof Income Certificate Issued by Competant Authority I-card Size Photo SSC Mark Sheet UID document xerox Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/27/2016 3:28:33 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1535664M20102015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2010 SSC Seat No E153566 SSC Marks Obtained 51.64

Applicant's Details

Applicant Name VISHAL RAJENDRA TUPE Mother's Name PUSHPA

Date of Birth 04-11-1994 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 28-09-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 35000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 43.00 Pass 2013 - 14 NVM 11 th Arts 2 45.00 Pass 2012 - 13 NVM SSC 1 51.64 Pass

Institution Details

UID Number 333975876107 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 00

College Adm.No 281 Quota Government Quota Joining Date 20-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name RAJENDRA NAMDEV TUPE Age 50(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 35000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 659 District Issuing Raigarh Taluka Issuing Panvel Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 1171 Issued in 2015 Registration No

Student Bank Account Details

Bank Name UNION BANK OF INDIA Bank Account No 320902010028539

Branch Name NERAL IFSC Code UBIN0532096 MICR Code 400026109

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/26/2016 11:23:11 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPe1554924M20122015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2012 SSC Seat No e155492 SSC Marks Obtained 56.73

Applicant's Details

Applicant Name JAYASHRI NARAYAN VIRALE Mother's Name KASTURI

Date of Birth 21-07-1996 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 03-11-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 45000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NMV 12th (Arts) 1 71.85 Pass 2013 - 14 NVM 11 th Arts 2 70.00 Pass 2012 - 13 NVM SSC 1 56.73 Pass

Institution Details

UID Number 321071128179 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 000

College Adm.No 4569 Quota Government Quota Joining Date 11-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name NARAYAN GOVIND VIRALE Age 45(yrs) Relation with Applicant Father Profession Labor

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 45000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 734 District Issuing Raigarh Taluka Issuing Panvel Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 1134 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125310510000631

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/26/2016 11:43:10 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1770974M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No E177097 SSC Marks Obtained 52.00

Applicant's Details

Applicant Name KALPESH KACHARU VIRALE Mother's Name FASABAI

Date of Birth 05-06-1997 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 18-12-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 48000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NERAL VIDYA MANDIR NERAL 12th (Arts) 1 58.00 Pass 2013 - 14 NERAL VIDYA MANDIR NERAL 11 th Arts 1 56.00 Pass 2012 - 13 SHRAMJIVI JANTA SSC 1 52.00 Pass VIDYAMANDIR POSHIR Institution Details

UID Number 855271275945 EID Number

Is Admission after Diploma? No Subject N.A CAP Number NA

College Adm.No 0316 Quota Government Quota Joining Date 10-07-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 9168949816, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Wanjarpada Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name KACHARU UNDRU VIRALE Age 42(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Wanjarpada Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 48000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel N.A Hostel Admission Date

Hostel Type N.A Is Mess Service Available? No Rent Per Month

Hostel/ Landlord Address N.A

Hostel/Landlord Contact Details N.A

Document Details

Caste Certificate No 1130/2013 District Issuing Raigarh Taluka Issuing Panvel Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A R.N. 4805 Issued in 2015 Registration No

Student Bank Account Details

Bank Name UNION BANK OF INDIA Bank Account No 320902010028802

Branch Name NERAL IFSC Code UBIN0532096 MICR Code 400026109

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/24/2016 10:55:26 AM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPE1547794M20122015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2012 SSC Seat No E154779 SSC Marks Obtained 63.20

Applicant's Details

Applicant Name AVINASH NARAYAN VIRLE Mother's Name TARABAI

Date of Birth 28-07-1997 Gender Male Is Resident of Maharashtra Maharashtra

Application Date 26-11-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 68000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 69.85 Pass 2013 - 14 NVM 11 th Arts 2 65.00 Pass 2012 - 13 NVM SSC 1 63.20 Pass

Institution Details

UID Number 212770597639 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 00

College Adm.No 191 Quota Government Quota Joining Date 23-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name NARAYAN GOVIND VIRLE Age 50(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 68000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 282 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 2442 Issued in 2015 Registration No

Student Bank Account Details

Bank Name UNION BANK OF INDIA Bank Account No 320902010028630

Branch Name NERAL IFSC Code UBIN0532096 MICR Code 400026109

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2 Application Form

Printed on 2/24/2016 4:48:06 PM GOI Post Matric Scholarship , 2015-2016 Course Bachelor of Arts Other Backward Class

Application Number APPe1761694M20132015

Application type New

Renewal Course Year N.A

Student SSC Details SSC Board MAHARASHTRA STATE BOARD OF SECONDARY AND HIGHER SECONDARY EDUCATION

Passing Year 2013 SSC Seat No e176169 SSC Marks Obtained 48.60

Applicant's Details

Applicant Name DISHA JEEVAN ZOMATE Mother's Name SARITA

Date of Birth 01-08-1997 Gender Female Is Resident of Maharashtra Maharashtra

Application Date 23-10-2015 Marital Status No Caste Category Other Backward Class

Caste Agari (169) Sub Caste

Orphan No Is Disabled No Disability Type N.A.

Is Applicant Salaried ? NO Applicant's Annual Income 0.00 Total Annual Income 40000.00

Student Prequalifying Details

Academic Year Institute Course Course Year Percentage Result 2014 - 15 NVM 12th (Arts) 1 53.00 Pass 2013 - 14 NMV 11 th Arts 2 50.00 Pass 2012 - 13 NVM SSC 1 49.00 Pass

Institution Details

UID Number 999820722065 EID Number

Is Admission after Diploma? No Subject N.A CAP Number 000

College Adm.No 235 Quota Government Quota Joining Date 18-06-2015

Is Fees Paid ? No Fee Paid 0.00 Fee Receipt No.

Fee Receipt Date N.A GrantType Non Granted

Contact Details

Residential Number: 0, MobileNumber: 7757027788, EmailAddress:

Address For Correspondence

Address:- Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

1 Of 2 Parent / Guardian Details Parent's name JEEVAN VALKU ZOMATE Age 50(yrs) Relation with Applicant Father Profession Farmer

Parmanent Address Location:- City:- Neral Pincode:- 410101 Taluka:- Karjat District:- Raigarh

Is Father Alive? Yes Annual Income 40000.00

Hostel Information

Is Staying at Hostel ? No Has Applied For Hostel ? No Is Studying in night school? No

Name of Landlord / Hostel Hostel Admission Date

Hostel Type Is Mess Service Available? No Rent Per Month 0.00

Hostel/ Landlord Address

Hostel/Landlord Contact Details

Document Details

Caste Certificate No 569 District Issuing Raigarh Taluka Issuing Karjat Office Office

Caste Validity N.A District Issuing N.A Scrutiny N.A Certificate No Office Committee No University Income Certificate No N.A 124 Issued in 2015 Registration No

Student Bank Account Details

Bank Name BANK OF INDIA Bank Account No 125310110000920

Branch Name NERAL IFSC Code BKID0001253 MICR Code 400013166

Document Attached

Declaration

The information furnished by me is complete and correct. I bear the complete responsibility for all the above information.

Applicant's Signature ______Applicant Parent's Signature ______

Principal's Signature ______

NOTE: PLEASE SUBMIT THE HARD COPY (PRINTOUT) OF THE APPLICATION FORM TO THE COLLEGE WITHIN 30 DAYS.

2 Of 2