Scribd Logo
Upload

Welcome to Scribd!

  • 4 views

    My Camu

    Uploaded by

    rayyanumar429

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    My Camu

    Uploaded by

    rayyanumar429
    4 views3 pages

    Original Title

    My Camu (1)

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    4 views3 pages

    My Camu

    Uploaded by

    rayyanumar429

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    Application Number: 22UCSA878

    JAMAL MOHAMED COLLEGE (Autonomous)


    7, Race Course Road, TIRUCHIRAPPALLI - 620020. INDIA

    APPLICATION FOR ADMISSION - (2022-2023)


    Under Graduate - Aided

    Course Choice 1: B.Sc COMPUTER SCIENCE Course Choice 2: B.Com


    For office use:
    Admitted in: __________________________________________ on ________________

    Language under part I *: Tamil Arabic French Hindi Urdu PRINCIPAL

    Applicant's Name: RAYYAN AHAMED

    Date of Birth : 04/05/2005 Nationality : IN

    Place of Birth : THANJAVUR Aadhar Card No. : 689653842282

    Religion & Community : ISLAM & BC Caste : LABBAI

    Blood Group : B -ve Mother Tongue : TAMIL

    Mobile Number : 9894891030 Email Id : [email protected]

    Distinction in Sports : - Extra Curricular Activities / : -


    Co-Curricular Activities

    Whether Differently-Abled : -

    Whether Son of Ex-Serviceman : -

    Hostel Accommodation : -

    PARTICULARS OF PREVIOUS ACADEMIC RECORD

    School Last Studied : ST.LITTLE FLOWER MATRICULATION HIGHER SECONDARY SCHOOL

    Address : KATTUR, TRICHY-19

    Qualifying Exam Passed : HSC

    Register No. : 5474863

    Maximum No. of
    Subjects Mark Marks Month & Year Attempts

    TAMIL 54 100 May/2022 1


    Maximum No. of
    Subjects Mark Marks Month & Year Attempts

    ENGLISH 74 100 May/2022 1


    ECONOMICS 87 100 May/2022 1
    COMMERCE 77 100 May/2022 1
    ACCOUNTANCY 77 100 May/2022 1
    COMPUTER APPLICATION 83 100 May/2022 1
    Total Marks Secured 452.00 600 Percentage: 75.33 %

    PARTICULARS OF THE PARENTS/GUARDIAN

    Father's Name : RIYAZ AHAMED R Occupation : ACCOUNTANT

    Annual Income : 120000 Contact No. : 9360160980

    Email Id : -

    Mother's Name : FOUJIYA BEGAM R Occupation : HOUSE WIFE

    Annual Income : - Contact No. : 9894891030

    Email Id : -

    Guardian's Name : - Contact No. : -

    Email Id : -

    Address for Communication Permanent Address

    3/1093,NETHAJI STREET, BURMA COLONY 3/1093,NETHAJI STREET, BURMA COLONY

    TRICHY TRICHY

    TAMILNADU TAMILNADU

    Pincode: 620019 Pincode: 620019

    Email: [email protected] Mobile: 9894891030

    NOTE
    1. Fill up the application form as per the data mentioned in your +2 Mark sheet & T.C.
    2. Omission or withholding details required or giving incorrect information will result in summary rejection of
    application or cancellation of admission.

    Our College does not Collect Capitation Fee for Admission to Any course

    DECLARATION
    * I declare that the particulars given here are correct and I will, if admitted, abide by the rules and regulations of the
    College. I assure that I will not take part in political or agitational activities inside or outside the College and I further
    promise that I will behave in a manner that will bring credit to the College and to our Country
    * I am aware of the law regarding the prohibition of ragging as well as the punishments and if found guilty of the
    offence of ragging and / or abetting ragging, is liable to be punished appropriately. I agree to abide by the
    punishment in case I am found guilty of ragging and / or abetting ragging.
    Date: 24-Jun-2022

    Station: Signature of the Parent/Guardian Signature of the Applicant


    Name:

    FOR OFFICE USE ONLY

    Signature of Staff Who Processed the Application: ___________________

    Date of Payment:

    Bill Number:

    You might also like