APPLICATION FOR UG ADMISSION 2022-23 Course Desired ---B.Sc (Mathematics)B.Sc (Physics)B.Sc (Electronics and Communication)B.Com GeneralB.Com Computer ApplicationsB.B.AB.Sc BiotechnologyB.Sc Microbiology & CLTB.Sc Computer ScienceB.Sc Information TechnologyB.A EnglishB.A TamilB.Com (Apprenticeship & Embedded Degree Program)B.Sc (Physical Education) 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 Medium of Instruction in +2 Part I Language preferred for X Part I Language preferred for XII S.S.L.C Register No. H.S.C Register No. TC No TC Date EMIS No 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 Are you a First Graduate: yesno 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 School last studied Name of the Board of Higher Secondary Examination passed Subject Marks Obtained Maximum Marks Month & YOP No of Attempts Copy of Higher Secondary Mark sheet Passport size photo 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.