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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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
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 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