Application Form

Personal Information

Name *
Date of Birth *
Age *
Place of Birth *
Nationality *
Religion *
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)