Directorate of Technical Education, Maharashtra State, Mumbai

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DIRECTORATE OF TECHNICAL EDUCATION MAHARASHTRA STATE, MUMBAI

OPTION/PREFERENCE FORM FOR CAP ROUND-I FOR ADMISSION TO POST S.S.C. DIPLOMA COURSES IN ENGINEERING / TECHNOLOGY FOR THE ACADEMIC YEAR 2011-2012

APPLICATION ID : VERSION NO : 2 S.S.C. SEAT NO : A334871 DEN11352194

Personal Details :
Full Name SHAIKH SHADAB RAFIQUE AHMED Type of Candidature Type A Date Of Birth April 3, 1995 PH Type NA Defence Type NA Home District Mumbai Category Open Gender Male

Options Given By Candidate :

Preference No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Choice Code 302661210 302161270 302561210 301261210 300761210 300761220 314261210 342161210 302629310 302129370 302529310 301229310 300729310 325729210 314229310 Preference No 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Choice Code 302138070 302538010 314538010 301237610 314537210 342137610 302337210 314237210 327337610 302619110 302119170 302860610 300737610 300737620 300961210

Declaration
I have read all therulesofadmissionandon understanding these Rules, I have filled this Option/Preference Form for CAP Round-I for consideration of submission of Option/Preference form at ARC for the admission to Post S.S.C. Diploma Courses in Engineering / Technology for the academic Year 20112012. The information given by me in this Option/Preference form is true to the best of my knowledge & belief. At later stage, if it is found that I have furnished wrong information then I am fully aware that the Option/Preference form submitted will not be altered/modified/changed in any case and I will be responsible for any further consequences arises due to my mistake. I also herewith undertake that, at later stage, if it is found that I have submitted false certificate(s)/document(s), I am aware that my admission stands cancelled and fees paid by me will be forfeited. Further I will be subjected to legal and/or penal action as per the provisions of the law.

Place : Date: Option/Preference Form Printed On : July 22, 2011 9:32:06 PM Option/Preference Form Last Modified On : July 22, 2011 9:31:36 PM

Signature of Candidate (SHAIKH SHADAB RAFIQUE AHMED)

Note : 1. Candidate should confirm the Option/Preference Form in person at ARC only. Do not send by post. 2. Get the Receipt-cum-Acknowledgement letter of the confirmation of the Online Option/Preference form for CAP Round-I duly signed by the ARC officer alongwith seal of that ARC office. Confirmation of online Option form of CAP Round-I at ARC is MANDATORY for getting allotment (if any). 3. If the Candidate fails to confirm this Option Form, then his Candidature will not be consider for Allotment of CAP Round-I. 4. If the Candidate gives the choices of Tution Fee Waiver Scheme (TFWS) and candidate gets an allotment then such candidates shall not be allowed to change Institution/course under any circumstances. 5. The Candiadate is required to pay Rs. 100/- (Rs. One Hundred Only) in cash at ARC as a processing fee for CAP Round-I.

http://mkcl.biz/DIPLOMA2011/CandidateModuleCAPRound1/frmOptionForm.aspx

22-07-2011