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SRI SA
I BH
AR
ATH C
OLLEGE OF ARTS AN
D S
CIENCE
Application No.
APPLICATION FORMU.G. DEGREE COURSE
Photo
Name : (as in SSLC / H.Sc Mark Statement)
COURSE APPLIED FOR
PART - 1 LANGUAGE Tamil Others
Father / Guardian’s Name :
Father / Guardian’s Profession :
Address for Communication :
District : Pin Code :
State : Nationality :
Phone No. : Religion :
Community : Caste :OC BC MBC SC ST(As per Tamil nadu Govt. Norms)
Gender : Date of Birth :Male Female(Date) (Month) (Year)
Hostel Accommodation Required :
Age :
Yes No
If, physically handicapped, specify the nature
Are you the son / daughter of Ex-Serviceman?
SRI SAI BHARATH COLLEGE OF ARTS & SCIENCE(Co- Education)
(Approved by Govt. of Tamil Nadu, Affi liated to Madurai Kamaraj University,Recognised by University Grants Commission Section 2 (F) UGC Act, New Delhi)
ODDANCHATRAM - VEDASANDUR HIGHWAY,NAVAMARATHUPATTY, DINDIGUL - 624 710.Ph : 04551-294433, Cell : 85080 60533, 85080 60522
www.srisaibharathcollege.com; Email : [email protected]
Qualifying Examination Passed : HSC or PD or Equivalent :
Month &Yearof Passing
No. ofAttempts
MaximumMarks
Marksobtained Register No.Subject
Part I : Tamil /Part II : EnglishPart III :1)2)3)4)
Total
Name of the School where studied last
Distinction in Sports / NCC / NSS / YRC
Student’s DeclarationI the undersigned, hereby declare that all the particulars given in this application are complete and
accurate to the best of my knowledge. If admitted tho the college, I agree to observe all the rules andregulations of the college and to pay all the fees and charges due to the college. If I am found, notadhering to the stipulated rules of discipline and code of conduct, I shall lose privilege of continuing asthe student of the college.
Signature of the applicant
Parent’s DeclarationI the undersigned, hereby declare that I have carefully studied the rules and regulations of the
College and that I will be responsible for all the activities of my ward. I also declare that I will remit all thedues on behalf of my ward in the college.
Signature of the Parent / GuardianPlace :
Date :
FOR OFFICE USE ONLYCertificates Verified :
10th Standard Mark SheetH.Sc / Pre - Degree Mark SheetTransfer Certificate
Community CertificateConduct CertificateOther Certificate
Signature of the Verified Staff :
Admitted in
Principal
Roll No.
Date
Admitted / Not Admitted
Application No.
APPLICATION FORMP.G. DEGREE COURSE
Photo
Name : (as in SSLC / H.Sc Mark Statement)
COURSE APPLIED FOR
Father / Guardian’s Name :
Father / Guardian’s Profession :
Address for Communication :
District : Pin Code :
State : Nationality :
Phone No. : Religion :
Community : Caste :OC BC MBC SC ST(As per Tamil nadu Govt. Norms)
Gender : Date of Birth :Male FemaleSRI S
AI B
HA
RAT
H COLLEGE OF ARTS A
ND
SCIENCE
(Date) (Month) (Year)
Hostel Accommodation Required :
Age :
Yes No
If, physically handicapped, specify the nature
Are you the son / daughter of Ex-Serviceman?
SRI SAI BHARATH COLLEGE OF ARTS & SCIENCE(Co- Education)
(Approved by Govt. of Tamil Nadu, Affi liated to Madurai Kamaraj University,Recognised by University Grants Commission Section 2 (F) UGC Act, New Delhi)
ODDANCHATRAM - VEDASANDUR HIGHWAY,NAVAMARATHUPATTY, DINDIGUL - 624 710.Ph : 04551-294433, Cell : 85080 60533, 85080 60522
www.srisaibharathcollege.com; Email : [email protected]
DETAILS OF QUALIFYING EXAMINATION PASSED(i) NAME OF THE DEGREE PASSED MAIN SUBJECT(ii) YEAR OF STUDY (iii) MEDIUM OF INSTRUCTION(iv) NAME AND ADDRESS
OF INSTITUTION LAST ATTENTED(v) NAME OF THE UNIVERSITY(vi) EXAMINATION PARTICULARS (Enclose attested xerox copy of mark statements)
Month & Year ofPassingRegister No.No. of
AttemptsClass
obtainedPercentage
of MarksMaximum
MarksTotal
MarksSecured
Subject
Part I Language......................................................
Part II English
(vii) Percentage Main / Core Ancy. / Allied Part III
Details of applications made for otherCourses / Colleges
Distinction in Sports / NCC / NSS / YRC
Student’s DeclarationI the undersigned, hereby declare that all the particulars given in this application are complete and accurate to the best
of my knowledge. If admitted tho the college, I agree to observe all the rules and regulations of the college and to pay all thefees and charges due to the college. If I am found, not adhering to the stipulated rules of discipline and code of conduct, I shalllose privilege of continuing as the student of the college.
Signature of the applicant
Parent’s DeclarationI the undersigned, hereby declare that I have carefully studied the rules and regulations of the College and that I will be
responsible for all the activities of my ward. I also declare that I will remit all the dues on behalf of my ward in the college.
Signature of the Parent / GuardianPlace :
Date :
FOR OFFICE USE ONLY
10th Standard Mark SheetH.Sc / Pre - Degree Mark SheetUG Marks StatementProvisional & Convocation
Transfer CertificateCommunity CertificateConduct CertificateEligibility
Admitted in
Principal
Roll No.
Date
Part III Main / Core......................................................
Ancillary / Allied I......................................................
Ancillary / Allied II......................................................
Admitted / Not AdmittedCertificates Verified :
Signature of the Verified Staff :
SRI SAI BHARATH COLLEGE OF EDUCATION(Co- Education)
(Approved by National Council of Teacher Education (NCTE), SRC / APP0010/62185 / 3-3-2015, New Delhi)ODDANCHATRAM - VEDASANDUR HIGHWAY,SULLERUMBU (POST), DINDIGUL - 624 710.Ph : 04551-294433, Cell : 85080 60533, 85080 60522
www.srisaibharathcollege.com; Email : [email protected]
SRI SA
I B
HA
RA
TH COLLEGE OF EDU
CATION
Application No.
APPLICATION FORM
Photo
Name : (as in SSLC / H.Sc Mark Statement)
COURSE APPLIED FOR
Father / Guardian’s Name :
Father / Guardian’s Profession :
Address for Communication :
District : Pin Code :
State : Nationality :
Phone No. : Religion :
Community : Caste :OC BC MBC SC ST(As per Tamil nadu Govt. Norms)
Gender : Date of Birth :Male Female(Date) (Month) (Year)
Hostel Accommodation Required :
Age :
Yes No
If, physically handicapped, specify the nature
Are you the son / daughter of Ex-Serviceman?
OPTIONAL :
DETAILS OF QUALIFYING EXAMINATION PASSED( i) NAME OF THE DEGREE PASSED MAIN SUBJECT(ii) YEAR OF STUDY (iii) MEDIUM OF INSTRUCTION(iv) NAME AND ADDRESS
OF INSTITUTION LAST ATTENTED(v) NAME OF THE UNIVERSITY(vi) EXAMINATION PARTICULARS (Enclose attested xerox copy of mark statements)
Month & Year ofPassingRegister No.No. of
AttemptsClass
obtainedPercentage
of MarksMaximum
MarksTotal
MarksSecured
Subject
Part I Language......................................................
Part II English
(vii) Percentage Main / Core Ancy. / Allied Part III
Details of applications made for otherCourses / Colleges
Distinction in Sports / NCC / NSS / YRC
Student’s DeclarationI the undersigned, hereby declare that all the particulars given in this application are complete and accurate to the best
of my knowledge. If admitted tho the college, I agree to observe all the rules and regulations of the college and to pay all thefees and charges due to the college. If I am found, not adhering to the stipulated rules of discipline and code of conduct, I shalllose privilege of continuing as the student of the college.
Signature of the applicant
Parent’s DeclarationI the undersigned, hereby declare that I have carefully studied the rules and regulations of the College and that I will be
responsible for all the activities of my ward. I also declare that I will remit all the dues on behalf of my ward in the college.
Signature of the Parent / GuardianPlace :
Date :
FOR OFFICE USE ONLYCertificates Verified :
10th Standard Mark SheetH.Sc / Pre - Degree Mark SheetUG Marks StatementProvisional & Convocation
Transfer CertificateCommunity CertificateConduct CertificateEligibility
Admitted in
Signature of the Verified Staff :
Principal
Roll No.
Date
Part III Main / Core......................................................
Ancillary / Allied I......................................................
Ancillary / Allied II......................................................
Admitted / Not Admitted
SRI SAI
BH
AR
ATH
N
URSING & PARAMED
ICA
L INSTITUTE
Application No.
APPLICATION FORM
Photo
Name : (as in SSLC / H.Sc Mark Statement)
COURSE APPLIED FOR
Father / Guardian’s Name :
Father / Guardian’s Profession :
Address for Communication :
District : Pin Code :
State : Nationality :
Phone No. : Religion :
Community : Caste :OC BC MBC SC ST(As per Tamil nadu Govt. Norms)
Gender : Date of Birth :Male Female(Date) (Month) (Year)
Hostel Accommodation Required :
Age :
Yes No
If, physically handicapped, specify the nature
Are you the son / daughter of Ex-Serviceman?
DEPARTMENT :
SRI SAI BHARATH NURSING & PARAMEDICAL INSTITUTE(Affiliated to The Dr. M.G.R. Medical University, Mother Terasa Women’s University & TNOU)
ODDANCHATRAM - VEDASANDUR HIGHWAY,SULLERUMBU (POST), DINDIGUL - 624 710.Ph : 04551-294433, Cell : 85080 60533, 85080 60522
www.srisaibharathcollege.com; Email : [email protected]
Qualifying Examination Passed : HSC or PD or Equivalent :
Month &Yearof Passing
No. ofAttempts
MaximumMarks
Marksobtained Register No.Subject
Part I : Tamil /Part II : EnglishPart III :1)2)3)4)
Total
Name of the School where studied last
Distinction in Sports / NCC / NSS / YRC
Student’s DeclarationI the undersigned, hereby declare that all the particulars given in this application are complete and
accurate to the best of my knowledge. If admitted tho the college, I agree to observe all the rules andregulations of the college and to pay all the fees and charges due to the college. If I am found, notadhering to the stipulated rules of discipline and code of conduct, I shall lose privilege of continuing asthe student of the college.
Signature of the applicant
Parent’s DeclarationI the undersigned, hereby declare that I have carefully studied the rules and regulations of the
College and that I will be responsible for all the activities of my ward. I also declare that I will remit all thedues on behalf of my ward in the college.
Signature of the Parent / GuardianPlace :
Date :
FOR OFFICE USE ONLYCertificates Verified :
10th Standard Mark SheetH.Sc / Pre - Degree Mark SheetTransfer Certificate
Community CertificateConduct CertificateOther Certificate
Signature of the Verified Staff :
Admitted in
Principal
Roll No.
Date
Admitted / Not Admitted