Your Name Affix Your Passport Size Photo Course B.Sc., Computer ScienceB.Sc., MathsB.Sc., PhysicsB.A. EnglishB.ComB.C.A Date of Birth Gender MaleFemaleTransgender Blood Group Community (as in T.C.) OCBCMBC / DNCSCSCASCAST Please Mention subdivision, if any Religion Roman Catholic (RC)ChristianHinduMuslim Others (Specify) Dalit Catholic / SC converted Catholic YESNO Letter from Parish Priest (RC Only) YESNO Nationality IndianOthers If Indian State If Others Mother Tongue Differently Abled YESNO (if yes)VisualHearingOrthopaedicalDyslexia Special Category YESNO (if yes)RefugeeOrphanSemi-orphan Parent’s Details Father Name Father Education Father Occupation Father Annual Income Mother Mother Education Mother Occupation Mother Annual Income Religion Aadhar No. Wards of Ex-Serviceman YesNo If Yes, ArmyNavyAir-ForceCoast-GuardParamilitary Services Extra Curricular ActivitiesNSSNCCScoutJRCNGCSports If Sports - Please Specify First generation graduate in your familyYesNo Name of the school, Place last studied UrbanRural Medium of InstructionTamilEnglish EMIS No Board of Examination PassedHSCCBSEISCEForeignOther Board / State Eligibility Cert.no Year of Passing Exam. Registration No. Marks obtained in Qualifying examination passed: H.Sc or Equivalent Language I Tamil Language II English Subject 1. Subject 2. Subject 3. Subject 4. Total Do you have Merit Certificate related to fine arts such as Drawing, Animation, Photography, Music etc. if yes, please attach photocopies along with the application form YesNo Present Address : Pin : Student Mobile No : Parent’s Mobile No : Email : Guardian’s Address : Pin : Guardian’s Mobile No : Email : DECLARATION I promise to abide by the rules and regulations of the college. All the particulars stated in this application are true to the best of my knowledge and belief.
