APPLICATION FOR PG ADMISSION 2021-22

Course Desired

Name in Block Letters as entered in H.S.C or any equivalent Examination

Email

Date of Birth as entered in H.S.C

Nationality

State: Tamil NaduOther State

If other state, Eligibility Certificate has to be produced at the time of Admission*

Religion

Community

Caste

Aadhar no of applicant

Blood Group

Parents Details

Parent Details Office Contact Details
Parent:

Father Name:

Mother Name:

Occupation:

Annual Income:

Address

Phone Number

Mobile Number

Guardian:

Name:

Occupation:

Annual Income:

Address

Phone Number

Mobile Number

Address for Communication

Door no / street
Village / City
District
Pincode

Mobile No. to which SMS to be sent

Student Mobile Number/ WhatsApp Number

Physically Handicapped, if yes details:

Tamil Origin from Andaman & Nicobar:
yesno

Daughter of Ex-Service Man:
yesno

Sports, if yes (level & details)
yesno

NCC
YesNo

NSS
YesNo

Hostel Accommodation required?
yesno

Transport facility required?
yesno

Location :

Name of the College last studied

Name of the Degree in UG

Month & Year of Passing

Semester

GPA

Part-I

Part-II

Part-III

I Semester
II Semester
III Semester
IV Semester
V Semester
VI Semester
CGPA

Declaration

I declare that all the particulars furnished above are true and correct. I submit that I will abide by the rules and
regulations of the college.
If the particulars furnished above are not true, I agree that my admission stands cancelled automatically.

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