Form Fee: 50 Roll No/Admission No

(For office Use)

Application for Eligibility (For Post Graduate Courses/PH.D/M Phill)

I wish to apply for the Eligibility for the academic year 20 - 20 1. Name of the Course to which application is sought

Year : 1st / 2nd / 3rd /4th / 5th

2. Name in full of the Applicant (in English capital Letters) Name as per last Mark sheet should be mentioned. N.R.I Student should write their name as it appears in their Passport.

3 Address-

4. Mother’s Name 5. Aadhar No ____________________________ 6. Email Id _____________________________________________________________________________________________ 7.Mobile No _____________________________

8. Nationality 9. Type: Maharashtrian / Non- Maharashtrian

10. Gender: Male / Female 11 Date of Birth:

DD MM YYYY

12. Reserved Category *

Do you belong to any of the following Reserved Categories?

If so attach a certificate of a Competent Authority in support of it

(Tick mark √ in

applicable box ) Open SC ST DT(A) NT(B) NT(C) NT(D) OBC SBC

Do you belong to the creamy layer of NT(C), NT (D) and OBC? Yes / No If you do not belong to the creamy layer, submit a certificate of a Competent Authority in support of it.

13. Are you a physically handicap? No / Yes ( If Yes specify type ) #

Particulars of the Qualifying Examination

1. Name of the Course

2. Name of University

3. Name of the College/Institute /University Dept

Seat No. Month & Year Of Passing Percentage Class/Grade

Please specify Educational gap details if any

Last Examination name Seat No. Month & Year Of Passing Percentage Class/Grade

14.Are you belong to the Minority? No/Yes ( if yes please specify type which has given below)

Linguistic: Religious: Signature of Candidate

Copies of Following attested certificates are annexed to application form

1 Statement of Marks of the qualifying examination 5 Cast certificate (For reserved category candidates)

2 Education Gap certificate 6 Cast validity certificate (For reserved category candidates)

3 Affidavit for change in name 7 Transfer Certificate

4 Domicile Certificate 8 Aadhar Card

To be filled by College/Institute / University Department Receipt No. Date: Eligible / Not Eligible

Asst. Sr. Asst. O.S./Registrar /HOD

Physical Handicap Types:

P1

Blind /Visually

impaired/अअअ/अअअअअअअअअअअ

P2 Dumb and Deaf /अअअअअअअअअ

P3

Orthopedically impaired/

अअअअअअअअअअअ

P4

Mentally

Challenged/अअअअअअअअ/अअअअअअ

अअअअअ

OT Other Physical disabilities

46

ANNEXURE ‘A’ ELIGIBILITY FEE 1. A student passing the qualifying examination and seeking admission FirstTime to First

Year of any Degree/Diploma/Certificate (U.G./P.G.) the Eligibility Fee will be as under :

Sr. Particulars Fees

No.

Non-professional Professional

Rs. Rs.

1. Within the State of Maharashtra 300 500

2. From outside the State of Maharashtra 500 1000

3. From any foreign country (Out of India) and 500 1000

(NRI/Foreign Citizen-Foreign National, P.I.O.)

4. Eligibility Form Fee 50 50

5. Equivalence Fee

500 500 (Per Candidate)

2. Admission charges for the submission of required documents will be Rs. 300 for Non-Professional courses & Rs. 500/- for Professional courses (Per Student) up to 30 day's from the last date prescribed for submission of documents. 3. If an affiliated College admits students not eligible and who are migrating from other University/Board and allowing to fill in Examination Form without obtaining Eligibility Certificate, a penalty of Rs.10,000/-per student would be imposed on the College and the performance of Examination of such students will also be canceled. 4. If any affiliated College admits any student not eligible for Under-graduate or Post-Graduate Courses of this University and allows him/her to fill in the Examination Form, a the penalty of Rs.5,000/- per student shall be imposed on the College and performance of the examination of such student shall be canceled. 5. The same rule applies to the University Department, Centres/Schools. The Head of University department/Director of Recognise Institute will have to pay penalty as above in case not an eligible candidate is allowed to fill in the University Examination form.