Tamil Nadu Agricultural University, Coimbatore - 641 003

2013130885 / 1
Tamil Nadu Agricultural University, Coimbatore - 641 003

APPLICATION FOR ADMISSION TO UNDERGRADUATE DEGREE PROGRAMS 2013-2014
*2013130885*
APPLICATION No.
2013130885
1. Date of Birth
TNAU - SBI Power Jyoti Journal Number :
Affix Passport
Size
Photograph
.......................................................
29/07/1996
(DD/MM/YYYY)
VISHNUPRIYA. V
2. Name of Candidate
(As in +2 Marksheet)
3. Gender
Male
Female
Others
5. Father's Name
M. VEERAPPAN
6. Mother's Name
V.THAMARAISELVI
7. Mailing Address
No:13, Mavadukurichi Post

Peravurani TK
Thanjavur D.T
Email
8 Mobile Number
9. Category
(Choose one)
4. Place of Birth
Pudhukottai
[email protected]
PIN Code
614804
9942968770
(Muslim)
BC
BCM
ST
Open Competition
10. (a) Code Number of the Caste
129
(See Appendix I of Brochure)
11.(a) Qualifying Examination Passed
MBC/DNC
(b) Name of the Caste
HSC(Academic)
SC
SCA
Yadhava
CBSE/Equivalent
HSC(Vocational)
(b) SerialNo of HSC/CBSE/
Equivalent Marksheet
7946989
(c) No of Appearances
(Attempts) :
2013130885 / 2
12. Marks Obtained

HSC Academic
Obtained
Vocational Group
Maximum
Mathematics
01
167
200
Physics
02
176
200
Chemistry
03
185
200
Agriculture Practices
Biology
04
173
200
Theory
09
Botany
05
PracticaI I
10
Zoology
06
Practical II
11
Com. Science/
07
BioTech/Mic.Bio/
Bio.Chem/
Hom.Sci.
Biology
Obtained
Maximum
08
Tick if 07 is Computer Science
13. Medium of Instruction :
Tamil
English
14. Nativity
Tamil Nadu
Other State
15. Citizenship
Indian
Others
(in qualifying Exams)
If others, specify
If others, specify
16. Particulars of Institutions last studied

Name of the Institution
Academic Year
Class Studied
Place
State
2012-2013 (XII)
Muvender Matr. Higher Secondary School,

+2Peravurani
Peravurani
Tamil Nadu
2011-2012 (XI)
Muvender Matr. Higher Secondary School,

+1Peravurani
Peravurani
Tamil Nadu
2010-2011 (X)
Govt Girls Higher secondary Scohool, Peravurani

SSLC
Peravurani
Tamil Nadu
SPECIAL RESERVATION
I have enclosed the following special reservation application along with necessary certificates
Differently Abled Person Desendent of Freedom Fighter
Dependent of Ex-Servicemen
Eminent Sports Person
NRI/Industry Sponsor
DECLARATION
Certified that the information furnished above are correct and true to the best of my knowledge. If found otherwise, I
undertake to forego my candidature and seat in the University if selected. I do hereby undertake that, I am aware that
there is no JOB GUARANTEE, I will not claim any extra facilities like scholarship, stipend, etc ., which are not in
operation, I am willing to study in the degree and campus chosen by me during counseling and will not claim change
of degree / campus. I do hereby undertake to abide by the rules in vogue and orders of the authorities of the
University to pay the tuition and other fees as prescribed and revised from time to time. I understand that semester
fees, once paid are not refundable.
Signature of the Parent / Guardian
Place
: Peravurani
Date
30/05/2013
Digital Signature
: VISHNUPRIYA V 30/05/2013 05:29 PM
Signature of the Candidate
2013130885 / 3
TNAU Copy
Applicant Copy
Tamil Nadu Agricultural University
Coimbatore - 641003

Coimbatore - 641003
State Bank of India

Power Jyoti Account No.: 32949069456
State Bank of India

Application Number
2013130885
Application Number
2013130885
Applicant Name
VISHNUPRIYA. V
Applicant Name
VISHNUPRIYA. V
Date of Birth
29/07/1996
Date of Birth
29/07/1996
To be Filled by Candidate
SBI Branch
SBI Branch
Date of Payment
Date of Payment
Application Fee : Rs 625/- (Rs. 325 for SC/SCA/ST)
(Rupees Six/Three Hundred Twenty Five only. Including Bank Charge

of Rs 25)

of Rs 25)
Signature of Applicant
To be Filled by Bank
Journal Number
Journal Number
Date
Date
Place
Authorized Signatory with Bank Seal
Bank Copy
Coimbatore - 641003
State Bank of India

Application Number
2013130885
Applicant Name
VISHNUPRIYA. V
Date of Birth
29/07/1996
SBI Branch
Date of Payment
of Rs 25)
Journal Number
Date
Place
Place
2013130885 / 4
INSTRUCTION TO APPLICANTS
1. In the completed and printed online application, paste a recent passport size photo of the candidate at the space
provided. Candidate and Parent should sign at appropriate places. Do not overwrite in the online filled application.
2. The Third page of the printed application contains TNAU-SBI POWER JYOTI challan form.
3. Application fee of Rs. 625 (Rs. 325 for SC/SCA/ST) including bank charge of Rs. 25 should be paid to
TNAU-POWER JYOTI ACCOUNT at any branch of State Bank of India (SBI) by showing the printed challan copy at
the bank counter.
4. Enclose the TNAU copy of the SBI TNAU-Power Jyoti account Challan along with the filled-in online application.
Enter the Journal Number provided by SBI in the first page of the printed application.
5. Attach photocopy of
a) Mark sheet of Qualifying Examination (HSC/CBSE or equivalent).
b) Tamil Nadu Community Certificate for Reservation Categories or 10th Mark sheet from Tamil Nadu School / Tamil
Nadu Permanent Residency Certificate for Open Competition candidates.
c) Attach any other required documents as given in the Admission Information Brochure.
Post the Printed, signed application with above attachments to:
The Dean Agriculture and Chairman Admissions
Coimbatore-641003
PS:
1. Those applying under Eminent Sports person quota or NRI/Industry Sponsor quota should personally submit the
application with necessary encolosures to the Dean (Agriculture ) and Chairman Admissions.
2. Use Application Number for all references.
3. Applications filed without payment of application fee will summarily be rejected.

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2013130885 / 1

Tamil Nadu Agricultural University, Coimbatore - 641 003

TNAU - SBI Power Jyoti Journal Number :

No:13, Mavadukurichi Post

10. (a) Code Number of the Caste

(See Appendix I of Brochure)

11.(a) Qualifying Examination Passed

(b) Name of the Caste

12. Marks Obtained

Tick if 07 is Computer Science

13. Medium of Instruction :

(in qualifying Exams)

16. Particulars of Institutions last studied

Muvender Matr. Higher Secondary School,

Muvender Matr. Higher Secondary School,

Govt Girls Higher secondary Scohool, Peravurani

Differently Abled Person Desendent of Freedom Fighter

Eminent Sports Person

: VISHNUPRIYA V 30/05/2013 05:29 PM

Signature of the Candidate

Tamil Nadu Agricultural University

State Bank of India

State Bank of India

Application Fee : Rs 625/- (Rs. 325 for SC/SCA/ST)

(Rupees Six/Three Hundred Twenty Five only. Including Bank Charge

(Rupees Six/Three Hundred Twenty Five only. Including Bank Charge

Authorized Signatory with Bank Seal

State Bank of India

Authorized Signatory with Bank Seal

Authorized Signatory with Bank Seal

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