APPLICATION FOR UG 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

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

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 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 School Leaving Certificate

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.

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