SREE BALAKRISHNA COLLEGE OF ARTS & SCIENCE

Select Course

Name of the candidate

Gender

Date of Birth

Blood Group

Community

Religion

Caste Name

Nationality

State

Maritial Status
Yes No

Aadhar No

Mother Tongue

Languages Known

Residential Address

Correspondance Address

Preferred E-Mail ID for Institution Notification

Last Studied School

Medium of Instruction

Passed Out Year

If Late Join , Reason for late Join

S.No	Subject	Total Mark	Your Mark
1		100
2		100
3		100
4		100
5		100
6		100

Section - C. Family Information

Father Name

Father Occupation

Father Annual Income

Father Mobile Number

Father Mail ID

Mother Name

Mother Occupation

Mother Annual Income

Guardian Name

Guardian Occupation

Guardian Annual Income

Section - D. Additional Details

1. Whether your Father/ Mother/ Guardian is Farmer/ Agriculture Labourer/ Registered Tenant ?

Yes No

2. Whether the applicant is physically challenged? If Yes, Indicate the type, percentage & produce the Xerox copy of the certificate

Yes No

3. Are you the daughter of Ex-Servicemen of Tamilnadu Origin ? If Yes, Produce a xerox copy of the Dependency Certificate of your Father

Yes No

4. Are you of Tamil origin from Andaman Nicobar Islands ?

Yes No

5. Destinction in Sports/ NCC/ NSS, Specify if Any the type

Section - E. Transport Details

1. How far is your native place away from the our college ?

2. Students are must come to college by College Transport, so please say your boarding point

3. Does the applicant need Hostel ? Hostel Accommodation will not be given to those who live within a radius of 20kms.

Yes No

Section - F. Attachments ( Maximum File Size : 3MB )

Student Image ( Only jpg,jpeg )*

10th Marksheet( Only PDF )*

12th Marksheet( Only PDF )

Original Transfer Certificate ( Only PDF )

Famliy Ration Card ( Only PDF )*

Income Certificate ( Only PDF )

If you Physically Challenged ? Certificate

If You Ex-Servicemen Daughter? Dependency Certificate

Distinction in Sports/ NCC/ NSS, Certicate

Student Signature ( Only jpg,jpeg )*

Parent/Guardian Signature ( Only jpg,jpeg )*

Section - F. Declaration

I declare that all the particulars furnished above are true and correct and I hereby confirm that I will abide by the rules and registration of the College.