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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

sivamagri@yahoo.com

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) :

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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

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TNAU Copy

Applicant Copy
Tamil Nadu Agricultural University
Coimbatore - 641003

Tamil Nadu Agricultural University

Coimbatore - 641003

State Bank of India

Power Jyoti Account No.: 32949069456

State Bank of India

Power Jyoti Account No.: 32949069456

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

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)

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

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

of Rs 25)

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

of Rs 25)

Signature of Applicant

Signature of Applicant

To be Filled by Bank

To be Filled by Bank
Journal Number

Journal Number

Date

Date

Place

Authorized Signatory with Bank Seal

Bank Copy
Tamil Nadu Agricultural University
Coimbatore - 641003

State Bank of India

Power Jyoti Account No.: 32949069456

Application Number

2013130885

Applicant Name

VISHNUPRIYA. V

Date of Birth

29/07/1996
To be Filled by Candidate

SBI Branch
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)

Signature of Applicant
To be Filled by Bank
Journal Number

Date
Place

Authorized Signatory with Bank Seal

Place

Authorized Signatory with Bank Seal

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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
Tamil Nadu Agricultural University
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.