Applicant Details

Applicant Photo
ApplicationID :1920DTR1000203084

Application ID Scheme Name

1920DTR1000203084 Rajarshi Chhatrapati Shahu
Maharaj Shikshan Shulkh
Shishyavrutti Yojna(EBC)

Department Name Applied Date

Directorate of Technical 10/10/2019
Education

Personal Details
ApplicationID :1920DTR1000203084

Full Name Mobile Number. Email ID

Sandeep Shivkant Mishra xxxxxx0283 s****[email protected]

Date Of Birth Gender Age

xx/xx/1998 Male 21

Religion Marital Status Applicant Full Name (As Per

Hindu Unmarried SSC Marksheet/ L.C.)
MISHRA SANDEEP SHIVKANT

Parent's/Guardian Mobile No Dependent Type

xxxxxx1135 -

Permanent address Details

ApplicationID :1920DTR1000203084

Address State District

ROOM NO.17 C WING RAMANUJMaharashtra Thane
APARTMENT,CHINCHPADA
ROAD,NEAR SAKET
Taluka Village
COLLEGE,Katemanivali,421306
Kalyan
Pincode
421306

IsCorrespondence Address
same as Permanent?
Yes

Correspondence Address Details

ApplicationID :1920DTR1000203084

Address State District

ROOM NO.17 C WING RAMANUJMAHARASHTRA Thane
APARTMENT,CHINCHPADA
ROAD,NEAR SAKET
Taluka Village
COLLEGE,Katemanivali,421306
Kalyan
Pincode
421306

Income Details
ApplicationID :1920DTR1000203084

Do you have Income Certificate? Does your Certificate have a Family Annual Income
Yes Barcode? 150000.00
No
Income Certificate No
41686089726

Issuing Authority Date of Issue

Nayab Tahsildar 11/09/2018

Domicile Details
ApplicationID :1920DTR1000203084

Are you Domicile of Do you have Domicile Relationship Type

Maharashtra? Certificate? Self
Yes Yes
Domicile Certificate No.
716/2016

Does your Certificate have a Applicant Name Issuing Authority

Barcode? MISHRA SANDEEP SHIVKANT Executive magistrate
No
Date of Issue
15/06/2016

Caste Details
ApplicationID :1920DTR1000203084

Caste Category
General

Personal Eligibility Details

ApplicationID :1920DTR1000203084

Are you Salaried? Disability of any Type?

No No
Parent's/Guardian's Details
ApplicationID :1920DTR1000203084

Is Father Alive? Father Name Is Father Salaried?

Yes SHIVKANT RAMAPATI MISHRA No

Is Mother Alive? Mother Name Is Mother Salaried?

Yes SAVITRI SHIVKANT MISHRA No

Past Qualification Details

ApplicationID :1920DTR1000203084

Qualification Level Stream Completed

S.S.C. (10 Std) SSC Completed

Institute State Institute District Institute Taluka

MAHARASHTRA Thane Kalyan

College Name / School Name Course Name Board/University

SSC MAHARASHTRA STATE BOARD
OF SECONDARY AND HIGHER
SECONDARY EDUCATION

Mode Admission Year Passing Year

Regular 2013 2014

Result Percentage Attempts

Passed 93.60 1

Is Gap? Qualification Level Stream

No H.S.C. (12 Std) Science

Completed Institute State Institute District

Completed MAHARASHTRA Thane

Institute Taluka College Name / School Name Course Name

Ambarnath SMT.CHM COLLEGE 12th Science

Board/University Mode Admission Year

MAHARASHTRA STATE BOARD Regular 2015
OF SECONDARY AND HIGHER
SECONDARY EDUCATION
Passing Year Result
2016 Passed

Percentage Attempts Is Gap?

64.31 1 No
Current Course Details
ApplicationID :1920DTR1000203084

Admission Year In Current Institute State Institute District

Course MAHARASHTRA Thane
2016
Institute Taluka Qualification Level
Thane Under Graduate Course

Stream College Name/school Name Course Name

Engineering N.Y.S.S.'s Datta Meghe College Bachelor of Engineering (B. E.)
of Engineering, Airoli, Navi - Chemical Engineering
Mumbai
Admission Type
Through CAP/Govt. Quota

Application Admission ID/CAP Year Of Study Completed Or Continue

ID First Year Completed
EN16236198
Admission Date Admission Year in
- College/Institute
2016

Percentage Result Fees Paid

53.3 Passed
Course Type
UnAided

Admission Through Open Or Gap Year Mode

Reserved Category? 0 Regular
General
Gap Reason CET / Merit Percentage
0

Admission Year In Current Institute State Institute District

Course MAHARASHTRA Thane
2016
Institute Taluka Qualification Level
Thane Under Graduate Course

Stream College Name/school Name Course Name

Engineering N.Y.S.S.'s Datta Meghe College Bachelor of Engineering (B. E.)
of Engineering, Airoli, Navi - Chemical Engineering
Mumbai
Admission Type
Through CAP/Govt. Quota
Application Admission ID/CAP Year Of Study Completed Or Continue
ID Second Year Completed
EN16236198
Admission Date Admission Year in
- College/Institute
2017

Percentage Result Fees Paid

79.8 Passed
Course Type
UnAided

Admission Through Open Or Gap Year Mode

Reserved Category? 0 Regular
General
Gap Reason CET / Merit Percentage
0

Admission Year In Current Institute State Institute District

Course MAHARASHTRA Thane
2016
Institute Taluka Qualification Level
Thane Under Graduate Course

Stream College Name/school Name Course Name

Engineering N.Y.S.S.'s Datta Meghe College Bachelor of Engineering (B. E.)
of Engineering, Airoli, Navi - Chemical Engineering
Mumbai
Admission Type
Through CAP/Govt. Quota

Application Admission ID/CAP Year Of Study Completed Or Continue

ID Third Year Completed
EN16236198
Admission Date Admission Year in
- College/Institute
2018

Percentage Result Fees Paid

76.45 Passed
Course Type
UnAided

Admission Through Open Or Gap Year Mode

Reserved Category? 0 Regular
General
 Gap Reason CET / Merit Percentage
0

Admission Year In Current Institute State Institute District

Course MAHARASHTRA Thane
2016
Institute Taluka Qualification Level
Thane Under Graduate Course

Stream College Name/school Name Course Name

Engineering N.Y.S.S.'s Datta Meghe College Bachelor of Engineering (B. E.)
of Engineering, Airoli, Navi - Chemical Engineering
Mumbai
Admission Type
Through CAP/Govt. Quota

Application Admission ID/CAP Year Of Study Completed Or Continue

ID Fourth Year Pursuing
EN16236198
Admission Date Admission Year in
20/08/19 College/Institute
-

Percentage Result Fees Paid

- - 42992.00

Course Type Admission Through Open Or Gap Year

UnAided Reserved Category? 0
General
Mode
Regular

Gap Reason CET / Merit Percentage

0

Hostel Details
ApplicationID :1920DTR1000203084

Hosteller / Day Scholor Type

Day Scholar

Additional Question
ApplicationID :1920DTR1000203084

Question Answer
Do you avail any scholarship / No Question
stipend ?
 your number of beneficiary in
family ?

Answer
Question Answer
1
Upload undertaking form that Pratidnyapatra.pdf
same year not more than two
beneficiary in family

Question
Is this a Renewal Application?

Answer
Question Answer
Yes
Enter previous year application 1819DTR1000087374
ID

Question Answer
Is taking benefit of TFWS No
(Tuition Fee Waiver Scheme)?

Benefits
ApplicationID :1920DTR1000203084

Tution Fee

84045.00
50% Tution Fee

42022.50
Exam Fee

1937.00
50% of Exam Fee

968.50

I / We agree to the terms and conditions of this scholarship. All information given in this application is valid to
best of my knowledge. I /We am /are punishable with penalties / punishments if any of the above mentioned
details is false as per the Indian Penal Code, 199 and 200. The decision given by the competent authority will be
final and will be accepted by me. If any surplus amount is received from the scholarship due to any reasons,
then I / We will return the amount at the earliest. I / We will be responsible for taking action against me / my
child against falsehood. I / We promise that we will take the scholarship / education fees as per the terms and
conditions of the concerned scheme. All the documents that I have linked to the application have been received
from the competent authority / authorities and the documents are valid and have been received by following the
required legal procedures. There is no modification / correction / alteration performed on them. I hereby certify
that the information provided is true and they are not false or fake. I am fully responsible for the false or fake
surveillance of the attached documents, and I am fully aware that I will be entitled to the penalty imposed by the
Indian Penal Code, 199 and 200.