GOVERNMENT OF MAHARASHTRA
Directorate of Technical Education 3, Mahapalika Marg, Post Box
1967,Mumbai- 400001.(M.S.).
Printable Application Form for Admission to Direct Second Year of
Post SSC Diploma in Engineering/Technology (Working Professional
Candidate) for AY 2025 - 2026
Application ID : DSD25100020 Version : 20
Mode Of Scrutiny : E-Scrutiny
Alloted e-Facilitation Center(e-FC) Details
e-FC Name: Government Polytechnic,
e-FC Code: FC1006
Murtijapur
e-FC Officer: Saoume Contact No.: 9850465599
Alloted on: 11-06-2025 04.01.22 AM
Personal Details
Full Name VISHAL T
Date of Birth
Gender Male 01-06-2015
(DD-MM-YYYY)
Nationality Indian Type of Candidature Maharashtra State Candidate - Type A
Category OPEN Sub Category Open
Mother Tongue Khasi Family Income(₹) 3,50,001 - 4,00,000
Applied For Orphan Yes Religion Christian
Religious Minority N.A Linguistic Minority N.A
Ex Service Personnel Defence
दिव्यांग(Physically
N.A. Defence Type Candidate - (Def-1) / माजी सैनिक
Challenged)
(डीइएफ-१)
Applied For EWS No
District from which
Ahliyanagar
candidate has Passed
Details of the Working Professional's Organization/Establishment
Latitude of Organization/ Establishment 20.9428
Longitude of Organization/ Establishment 77.79495583333333
Address of Organization/ Establishment xyzhhh jhuh
District of the Organization/ Establishment Hingoli
Status of Candidate working in Central Government’s
Organizations/ Industries/ Companies / Autonomous No
Organizations
Qualification Details
HSC Board Maharashtra State Board of Secondary and Higher Secondary Education, Pune
HSC Passing year 2024
HSC Roll no M000001
Full name VISHAL T
Mother's name H VIJAYA
Subjects Physics, Chemistry, Mathematics, Electrical Maintenance
Examination Marks Obtained Marks Out Of Percentage
HSC Aggregate 449 600 74.83
10th/S.S.C. Mathematics 0 0
10th/S.S.C. Science 0 10
10th/S.S.C. English 0 100
Payment Details
Sr.No. Payment Date Total Amount Bank Reference ID Payment ID Transaction Amount
1 08-06-2025 04:16 AM 400 /- order_QedHgcbbiKBfeF pay_QedHqhcGqpwvkk 400 /-
Documents List
Sr.No. List of required documents to be submitted at the time of verification in FC Status
1. Statement of marks obtained at 10th/SSC or its Equivalent Examination uploaded
2. Statement of marks obtained at 12th/HSC or its Equivalent Examination. uploaded
3. School Leaving Certificate after passing Qualifying Examination. Not Uploaded
The School Leaving Certificate indicating the Nationality of the Candidate as Indian Or The
4. Not Uploaded
Place Of Birth In India.
5. Birth Certificate of the Candidate indicating the place of birth in Maharashtra. uploaded
6. Defence Service Certificate Proforma - C uploaded
7. PROFORMA U [FOR ORPHAN CANDIDATES] uploaded
Note : As per your selection of scrutiny mode[e-Scrutiny Mode] - Your application will be processed by the
allocated eFC. In case of any discrepancy in the application form the list of discrepancies will be visible in your login
dashboard.
Declaration: I have read all the rules of admission and on understanding these Rules, I have filled this Application
Form for consideration of submission of Application Form at FC for the admission to Direct Second Year of Post SSC
Diploma in Engineering/Technology (Working Professional Candidate) for AY 2025 - 2026. The information given
by me in this application is true to the best of my knowledge & belief. If at later stage, it is found that I have
furnished wrong information and/or submitted false certificate(s), I am aware that my admission stands cancelled
and fees paid by me will be forfeited. Further I will be subject to legal and/or penal action as per the provisions of
the law.
Date 11-06-2025
Signature of the Candidate
Place
(VISHAL T)
Last modified by DSD25100020 Printed On 11-06-2025
Last modified on 11-06-2025 Printed By DSD25100020
