Application No.

SRI CHANDRASEKHARENDRA SARASWATHI AFFIX LATEST

VISWA MAHAVIDYALAYA PASSPORT SIZE
Enathur, Kanchipuram - 631 561, Tamilnadu. COLOUR
(Declared as Deemed to be University u/s 3 of UGC Act 1956 vide notification No.
PHOTOGRAPH
F.9-9/92-U3 dated 26 May 1993 of the GOI)
HERE
Managed by Sri Kanchi Kamakoti Peetam Charitable Trust

APPLICATION FORM FOR ADMISSION

Name of the Candidate : ...................................................................................................................
Course Applied : .......................................................................................................................
Regular / Lateral / Part - Time : ....................................................................................................................
SECTION I - PERSONAL DETAILS
1. Name (in capital letters as
recorded in school certificate)
2. Date of Birth (DD/MM/YYYY)
Age (as on 01.07.2011) *
3. Sex (M / F)
4. Nationality

5. Name of Father / Guardian

Occupation
Annual Income

6. Mother’s Name
Occupation
Annual Income
7. Mother Tongue
8. Religion
9. Community
(OC / BC / MBC / SC / ST) a
10. Address for Correspondence
Door No. & Street
Town
District & State
PIN
Telephone No. with STD Code
Mobile No. of the Parent
11. E-mail
12. Permanent Address
Door No. & Street
Town
District & State
PIN
Telephone No. with STD Code
* Maximum age limit for BE/B.Tech (Full Time) courses is 20 years
a Proof to be attached for all categories other than OC
SECTION II - ACADEMIC BACKGROUND
12. Educational Qualifications (Fill the appropriate columns only)

Month & Year of Overall Grade with

Class / Degree Board / University Percentage Medium of Instruction
Passing

SSC / X Std

Intermediate /
HSC / ISC

Degree / Diploma

P.G. Degree

M.Phil.

(Enclose Copies of Mark Sheets & Certificates, Transfer and Conduct Certificates)

13. Marks at the Qualifying Examination for B.E. (Full Time) courses only
(Intermediate / HSC / ISC)

Subject Max.Marks Including Practical Marks Obtained Month & Year of Passing

Mathematics

Physics

Chemistry

14. Rank / Score in AIEEE / GATE / Any National :

or State level Entrance Examination
(Enclose Copy of the Rank Card)

15. Are you otherwise abled applicant ? : Yes / No

(If yes, Enclose Authorized Certificate)

16. Choice of the Branch in B.E. / B.Tech., (Mention three preferences)

a) b) c)

17. Extra Curricular Activities : NCC / NSS / Sports / Others

Name of the Level (State /

Award Won Organizing Authority Month & Year
Sports Event National / International)

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18. RESEARCH PROPOSAL DETAILS (Only for Ph.D. candidates )

Type of Research Disciplinary / Inter - Disciplinary

Topic of Research
Broad Area of Research
Name of the Guide with Designation
and Official Address
Name of the Co-Guide with Designation and
Official Address (For Inter-disciplinary)

Recommendation of the Guide

DECLARATION BY THE CANDIDATE

I certify that all information submitted for the admission process including the application, personal and
any other supporting materials are factually true, and honestly presented. I understand that I may be
subject to a range of possible disciplinary actions, including admission revocation or expulsion, if the
information is found to be false. I shall abide by the code of conduct formulated by the University from time
to time and the decision of the university authorities in all such matters shall be final and binding on me.

Place :

Date : Signature of the Candidate

DECLARATION BY THE PARENT

I, Mr/Mrs............................................................................................................................. do hereby guarantee

that my son / daughter / ward .......................................................... if given admission for the course
applied in Sri Chandrasekharendra Saraswathi Viswa Mahavidyalaya, will not take part in any activity
prejudicial to the interests of the institution. I vouch for his / her good behaviour and conduct during the
entire course of studies. If he / she violates any of the rules and regulations of Viswa Mahavidyalaya, my
son / daughter / ward and I shall abide by any disciplinary action, which may be taken by the university
authorities. The decision of the authorities in this respect shall be the final and binding on us.

PHOTOGRAPH
OF THE
PARENT /
GUARDIAN

Place :

Date : Signature of the Parent / Guardian

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 CHECK LIST OF ENCLOSURES

* Proof of Date of Birth

* Recently taken Photographs - 3 Passport Size and 3 Stamp size
* Photocopies of
* Community Certificate
* Mark Sheets of SSC, HSC, Degree / Diploma / P.G.Degree / M.Phil. (as applicable)
* Transfer Certificate
* Rank / Score card in Entrance Examinations like AIEEE/GATE etc.
* Authorized certificate in case of otherwise abled applicants
* Certificates of achievements in Sports
* Photograph of the Parent / Parents / Guardian

INSTRUCTIONS

1. Duly filled in applications should reach The Registrar, SCSVMV University on or before
the last date.

2. For applications downloaded from the university’s website, please quote the application
number given at the time of downloading and fill it in the relevant places without fail.

3. Filled in downloaded applications must be sent to the following address along with the
application fees in the form of Demand Draft in favouring of “The Registrar, SCSVMV
University”, payable at Chennai.

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