SREE MUTHUKUMARASWAMY COLLEGE
Plot #92/1&9, 8th Block, Muthamizh Nagar, Kodungaiyur. Chennai - 600 118
Phone# (044)25544574, (044)25544577 Email Id: smkc_1997@yahoo.com
|
|||||||
---|---|---|---|---|---|---|---|
Application Id: |
Course code: |
Course Name: |
Shift Timing: |
||||
Student Name: |
Date of Birth: |
||||||
Gender: |
Religion: |
||||||
Community: |
Caste: |
||||||
Nationality: |
Blood Group: |
||||||
Mode of Transport: |
Marital Status: |
||||||
Mother Tongue: |
Land Line Number: |
||||||
School Where Last Studied: |
Sports Description: |
||||||
Interested in NSS Activites: |
Mobile Number: |
||||||
Email Id: |
Aadhar Card No: |
||||||
Have you applied for any other course: |
|||||||
Proficiency in other fields (Arts, Music, Dance, etc.,): |
|||||||
Are you of tamil Nadu Origin from Andaman and Nicobar Islands: |
|||||||
Are you from other State/ NRI: |
|||||||
Do you belongs to linguistic minority: |
|||||||
Differently Abled: |
|||||||
Contact Details | |||||||
Address: |
|||||||
Parent Information | |||||||
Parent Name | Relation | Occupation | Education | Mobile number | Email Id | Annual Income | Father is Ex service Men (Y/N) |
+2 Educational Details | |||||||
Class | Institution Name | Register Number | Medium | Specialization | Board | Stream | Month and Passed Year |
XII Subject Deatails | |||||||
Subject | Marks | Total Marks | No.of Attempts | ||||
Subtotal(without Language and english): | Subtotal Percentage(%): | ||||||
Total(With Language and english): | Percentage(%): | ||||||
I declare that all the particulars furnished above are true and correct (In case the furnished information is found to be incorrect later the application/admission will be rejected). I hereby agree that I will abide by the rules and regulations of the college that are in force from time to time. | |||||||
Place: Date: | Signature of the Father/Mother/Guardian: |
Signature of the Applicant |