COURSE APPLIED FOR *  
NAME OF THE APPLICANT *  
GENDER*  
DATE OF BIRTH *  
COMMUNITY*   CASTE
NATIONALITY*  
RELIGION*  
STATE*  
NAME OF THE FATHER / GUARDIAN AND ANNUAL INCOME*  
NAME OF MOTHER*  
ADDRESS FOR COMMUNICATION *  
MAIL ID *  
AADHAR NO *  
MOBILE NO *  
ARE YOU DIFFERENTLY ABLED ?  
ARE YOU A SON /DAUGHTER OF EX-SERVICEMAN OF TAMILNADU ORIGIN ?  
ARE YOU OF TAMIL ORIGIN FROM ANDAMAN & NICOBAR ISLANDS ?  
DISTINCTION IN SPORTS  

PARTICIPATED IN NCC / NSS ?

If yes , furnish details :

 
NAME OF THE LAST STUDIED INSTITUTION  
   
COURSE DETAILS BOARD/UNIVERSITY MONTH&YEAR OF PASSING COURSE DURATION MAJOR SUBJECTS % OF MARKS CLASS OBTAINED
             
UG DEGREE *
             
HSC *
             
SSLC *
             
   
PAYMENT DETAILS
DATE OF PAYMENT *
NAME OF THE BANK *
CHALLAN NO / TRANSACTION NO *
AMOUNT OF Rs. * ( Including GST )