Application Form
Personal Information
Name
*
Date of Birth
*
Age
*
Place of Birth
*
Nationality
*
Religion
*
Community
OC
BC
MBC
SC/ST
Caste
*
Blood Group
*
Mother Tongue
*
Aadhar No.
*
Qualifying Examination Passed, H.Sc., or Equivalent
*
Are you a first generation Learner
Yes
No
Are you Differently Abled, If so specify
Yes
No
Specify
Are you a Daughter of an Ex-Service man
Yes
No
Achievements in NCC/NSS Distinction in Sports (District/State/National)
*
Particulars of marks
H.Sc.
CBSE
Other State
Details of marks (Optional)
Year & Month
Reg No
Subject
Max. Marks
Marks Obtained
No. of Attempts
Total
Name and Location (District) of School studied
*
Medium of Instruction in XII
*
Course applied for
*
:-
Shift 1 (9:00 am. to 2:15 pm.)
B.A Tamil
B.A English
B.Sc Biochemistry
B.Sc Computer Science
B.Sc Mathematics
BBA
BCA
B.Com General
B.Com ISM
B.A Economics
B.Sc Physics with Computer Applications
B.A Tourism and Travel Management
B.Sc Psychology
Shift 2 (12:00 pm. to 5:00 pm.)
B.Com Corporate Secretaryship
B.Sc Computer Science
B.Com Accounting and Finance
B.A Historical Studies
B.A Sociology
11th Mark Sheet (optional)
12th Mark Sheet (optional)
Upload Recent Passport Size Photo (optional)
Details of Parents / Guardian
Father / Mother / Guardian Name
*
Occupation
*
Income(Yr)
*
Off. Address
*
Mobile No.
*
Email Id.
*
Father / Mother / Guardian Photo (optional)
Permanent Address
*
Address for Communication
*
BANK NAME
AXIS BANK LTD, AMBATTUR, CHENNAI-600053
IFSC CODE
UTIB0000865
ACCOUNT NO
916020073286619
Kindly pay the application fee Rs.200/- to the above account and enter the Transaction ID below.
Transaction ID (optional)
Submit