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Application - 2

This document is an application form for admission to the first year of undergraduate programs at Dhanalakshmi College of Engineering in Chennai for the academic year 200-0. The form requests information such as the applicant's name, address, date of birth, qualifying exam details, course preferences, and a declaration signed by the applicant and parent/guardian. It also lists the required documents to submit along with the application such as mark sheets and certificates.

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100% found this document useful (2 votes)
59 views3 pages

Application - 2

This document is an application form for admission to the first year of undergraduate programs at Dhanalakshmi College of Engineering in Chennai for the academic year 200-0. The form requests information such as the applicant's name, address, date of birth, qualifying exam details, course preferences, and a declaration signed by the applicant and parent/guardian. It also lists the required documents to submit along with the application such as mark sheets and certificates.

Uploaded by

arunk7004
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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DHANALAKSHMI COLLEGE OF ENGINEERING, CHENNAI

(Approved by the All India Council Of Technical Education and affiliated to Anna University)
APPLICATION FORM FOR ADMISSION DURING 200 - 0
FIRST YEAR

[Put tick in the appropriate box, against columns 6, 7, 8(i), 8(iv), and 9(i)]

1. Name of the applicant, in block letters : ………………………………..


(as given in +2 mark sheet)
2 Nos. latest,
colour,
2. i) Residential address : ………………………………..
passport size
………………………………..
photo (one
………………………………..
affixed and one
Pincode : ……………Phone : …………..
annexed)
ii) Address for communication : …………………………………
…………………………………
…………………………………
Pincode : ……………Phone : …………..

3. i) Name of the parent / guardian : …………………………………


ii) Occupation of the parent / guardian : …………………………………
iii) Office / Establishment address : …………………………………
…………………………………
………………………………….
Pincode : ……………Phone : …………..

4. I) Date of birth :
Date Month Year

Date, month and year should be entered only as two digit number.
Example, 5-1-1977 should be entered as
0 5 0 1 7 7

Ii ) Age as on 1st July 2006 : ……….years………..months

5. Nativity :

6. Sex : Male Female

7. Community : OC BC MBC/DNT
Attach a xerox copyof the permanent
Community certificate in cases other than OC SC/ST
8. I) Qualifying examination passed : HSC (Academic) HSC (Vocational)
Equivalent

I i) Examining body : State Board CBSE ISC

III) Name and address of the school of +2 study : English Tamil Others(specify)……

iv) Medium of instruction in +2:

Subject Maximum marks Marks obtained Number of Month and year


attempts of passing
Tamil
English
Mathematics
Physics
Chemistry
Biology/Botany
Zoology
Total

* Enter only the digit (Example: 1/2/3…..) against ‘Number of attempts’ as may be applicable

9. I) Whether appeared for the :


Tamil Nadu Professional Courses Yes No
Entrance Examinations (TNPCEE)

ii) If yes, mention the Registration Number :

iii) Year of appearance :

iv) a) Average in Mathematics, Physics


and Chemistry out of 100 :

b) Marks obtained in TNPCEE : M - _____/50 ; PS - _____/50

c) Total (a + b) out of 200 :

10. Course opted : Electronics and Communication Engineering


(Indicate the serial number in
the order of preference) Electrical and Electronics Engineering

Computer Science and Engineering

Information Technology
DECLARATION

I,…………………………………………………………….(Name in full), Son/Daughter of


……………………………………Hereby solemnly affirm that the information furnished in the
Application are true, correct complete.

I further affirm that in case any information is found to be otherwise I agree to forfeit the seat
and be removed from the rolls in the institution, at whatever stage of study I may be, at that particular
point of time besides subjecting myself to criminal prosecution.

Place :…………………….

Date :…………………….

Parent’s / Guardian signature Signature of the applicant

NOTE: The application should be accompanied by Xerox copies of the following :


1. SSLC mark sheet
2. +2 mark sheet
3. TNPCEE Hall ticket and mark SHEET
4. Transfer certificate / conduct certificate
5. Community certificate
The originals should be produced and surrendered at the time of admission.

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