APPLICATION FORM FOR ADMISSION TO MBA COURSE 2019-2020

  Application Number:105087

1.TANCET 2019 Registration

24111024
Number :

2.Name : SITHEN ARUL RAGHUNATHAN

Affix your passport size
3.Name of Parent/Guardian : RAGHUNATHAN photo
4.Address for Communication : 35, SHANMUGAPERUMAN STREET,
KIZHPERUMPAKAM,VILLUPURAM  605588.

5.Email Id : sithenarul@yahoo.com

6.Contact Telephone Number : --

7.Mobile Number : 8220500835

8.Sex : Male

9.Citizenship : INDIAN

10.Nativity : TAMIL NADU

11.Srilankan Tamil Refugee : NO

12.Place of Birth : VILLUPURAM

13.Mother Tongue : TAMIL

14.Date of Birth : 29-05-1999

15.Name of the Community : BC

16.Caste Code : 17024

17.Religion : HINDU

18.Name of the Caste : AGAMUDAYAR

19.Differently abled Quota? : No

20.Qualifying Degree : B.A. / B.SC. / B.COM. / BBA

21.Pattern of Study (in years) : (10+2+3)

22.Appearance in Final Year PASSED  (May 2019)

Exam? :

23.TANCET Marks in 2019 : 23

24.School/College study information

Year of
Class/Degree Name of the School/College District State
Passing

XI 2015 SACRED HEART CON HR SEC SCHOOL VILLUPURAM TAMIL NADU

XII/Diploma 2016 SACRED HEART CON HR SEC SCHOOL VILLUPURAM TAMIL NADU

ACHARIYA ARTS AND SCIENCE

Degree 2019 VILLIANUR PUDHUCHEERY
COLLEGE
25.Details of Marks in UG Degree qualifying examinations
a).UG degree : BACHELOR OF BUSINESS ADMINISTRATION
b).Name of the College with ACHARIYA ARTS AND SCIENCE COLLEGE,URUVAIYAR
Address :
c).Name of the University : PONDICHEERY UNIVERSITY

Month and Year of

Semester/Year Maximum Marks Marks Obtained
Passing

I NOVEMBER 2016 400 177

II MAY 2017 500 228

III NOVEMBER 2017 500 253

IV MAY 2018 500 224

V NOVEMBER 2018 500 242

VI MAY 2019 400 268

  Overall Total 2800 1384

Total % of Marks 49.42

26.Average Percentage of Marks upto Pre-final Semester/Year

Total Maximum Marks Total Marks Obtained Percentage of Marks

2400 1116 46.5

27.Demand Draft details

DD Number DD Amount (Rs) DD Date Bank Name and Branch

INDIAN BANK-SACRED
393790 300 24-07-2019
HEART COVENT BRANCH
 DECLARATION BY THE APPLICANT

All the information furnished prepage are true to the best of my knowledge. I am aware that any wrong information
or suppression of information may result in punitive action in addition to the summary cancellation of my candidature
for admission and forfeiture of the fee paid.

I have the required qualification for admission to MBA/MCA Degree Programme as prescribed.
I have studied Bachelor's Degree course in 10+2+3/4/5 years pattern (or) 10 + 3 years Diploma + 3 years pattern.
I have not studied B.E. / B.Tech Degree through distance / week end mode.

I am also aware that a pass in recognized bachelor's degree of minimum 3 years duration in 10+2+3/4/5 years pattern
and obtained at least 50% (45% in case of candidates belonging to reserved category) at the qualifying examination is the
minimum eligibility required for admission to PG courses as per AICTE norms.

Place:  
Date: Signature of the Applicant

CHECKLIST
(To be filled by Applicant)

Tick Tick
   
( ) ( )
1.Self Attested Photograph affixing on the 7.Self Attested Photocopy of TANCET 2019 Hall
Application. Ticket.
2.Self Attested Photocopy of Plus Two Mark 8.Self Attested Photocopy of TANCET 2019 Mark
Sheet / Diploma Certificate. Sheet.
3.Self Attested Photocopy of All Semester
9.Self Attested Photocopy of Nativity Certificate
Mark Sheets (All appearances) of qualifying
(if applicable).
Examination (Xeroxing both sides).
4.Self Attested Photocopy of Degree or 10.District Medical Board Certificate (for
Provisional Certificate. Differently Abled Persons only).

5.Self Attested Photocopy of Transfer 11.Sri Lankan Tamil Refugee certificate -If
Certificate. applicable
6.Self Attested Photocopy of Permanent
Community Card for ST, SC, SCA, MBC & DNC, 12.Included Original Demand Draft (DD)
BC, BCM.

Note

After submitting online, printout of the application, relevant enclosures and the original Demand Draft(DD) must be
sent by post or dropped in a box at the office of the "The Secretary, TN MBA / MCA Admissions - 2019, Government
College of Technology, Coimbatore 641 013" before 03-08-2019. Use only in the A4 size cover duly affixing the
downloaded address label.

FOR OFFICE USE ONLY

The Candidate is Eligible / Not Eligible
( If Not Eligible Specify the Reason)  

Scrutinizing Staff Name

Signature