Online Application

ANNAMALAI UNIVERSITY APPLICATION NO.

DIRECTORATE OF DISTANCE EDUCATION
Application for Admission to
301568
Preparatory / Pre-Foundation / Certificate / FOR OFFICE USE ONLY

SPOT CODE
Diploma / P.G. Diploma / Under Graduate / ENROLMENT NO.

Post Graduate / Double Degree Programme

including Lateral Entry 2016 - 2017
(REFER PROSPECTUS FOR DETAILS) (Make a tick-mark () in square q wherever applicable)
1. Programme
Code & Name PASSPORT SIZE
PHOTO
Double Degree Programme q Lateral Entry/Direct II / III Year Programme q duly signed
2. PCP Zone (See Prospectus) Medium: English q Tamil q and attested
by an authorised
3. OPTIONAL SUBJECT CHOSEN : (See Prospectus) officer

Preparatory, Pre-Foundation Programmes: Part - I Part - III

U.G. Programmes : Part-I :

Optional Papers : I Year: II Year: III Year: P.G. : I Year: II Year:

Programmes (optionals)
4. Name in CAPITAL LETTERS (In English):

5. Fathers Name / Husbands Name

6. ADDRESS IN CAPITAL LETTERS (to which communications and lessons are to be sent)

PIN

Dist.
Phone No.
State (with STD Code)
E-mail ID Mobile No. :

7. Date of birth (in the Christian era) Date Month Year

(as entered in the School Leaving Certificate) 1 9

8. Sex: Male q Female q Transgender q 9. Nationality:

10. Religion: Hindu q Muslim q Christian q Others (specify)

11. Community : SC SCA ST MBC BC OBC BCM OC DNC

12. Differently Abled: YES q NO q Blind q Others Percentage

13. Qualifying Examination Passed:

Name of the Duration of Name of the Reg. No. % Class
Examination Programme University/Board and Year of Marks Obtained

Main :

Ancillary :
Application Fee ` 100/- in person and ` 150/- by post.
 14. Pattern of passing 11+2+2 q 11+1+3 q 10+2+3 q
the Degree Examination: (Direct OUS UG & PG Degree are not Eligible)

15. Occupation : Government q Non-Government q Others q

16. Are you presently undergoing any
other programmes, in any institution Yes q No q
(including DDE)? If yes, give details :

17. Option for Study Material: Hardcopy q Softcopy q

DECLARATION
i) I declare that the particulars given above are correct and I submit myself to the disciplinary and regularly jurisdiction of the authorities of
the University who are vested with the rights to exercise discipline under the Act, the Statutes, and the Ordinances, and will strictly observe
the rules and regulations that have been framed thereunder by the University.
ii) I hereby agree that with regard to disputes arising in all matters including admission, returning of original certificates after verification,
sending of lessons, PCPs, response sheets, examinations, remittance of fees, etc., only the Courts and Tribunals having jurisdiction over
Annamalainagar (Chidambaram), Cuddalore District, Tamilnadu and not over any other place, shall have jurisdiction for the purpose of filing a
suit or preferring complaint under the Consumer Protection Act or any other law for the time being in force or for taking any legal action against
the Directorate of Distance Education or the Controller of Examinations, Annamalai University.

Place:
Date: Signature of the Applicant

Enclosures: (1) Photostat Copy of Degree Certificate/Pass / Provisional Certificate q (5) Photostat Copy of Community Certificate q
(Check List) (2) Photostat Copy of Mark List or Consolidated Mark List (except OC)
q (6) Scanning Slip q
(3) Photostat Copy of Transfer or Migration Certificate q
(4) Identity Card duly filled in q
(Do not enclose original certificates)

FOR OFFICE USE ONLY ELIGIBLE q NOT ELIGIBLE q

CERTIFICATES VERIFIED REMITTANCE PARTICULARS
1) Degree/Provisional/Pass Certificate q Name of the Bank :
2) Transfer OR Migration Certificate q Draft/Challan Number :
3) Mark List (10th/12th Standard) q Amount :
4) 8th Standard Transfer Certificate q Date :
5) 10th Standard Transfer Certificate q
Provisionally selected for admission. Spot selection subject to confirmation by the Director

Official-in-Charge Section Head Officer-in-charge

For use in Spot Admission

Whether Original Certificate/Mark Lists Whether Lessons received Yes q No q

received after verification? Yes q No q If yes, Complete set q Incomplete set q

Signature of the Candidate

Admission Confirmed

Official-in-Charge Section Head DIRECTOR

 DATA SHEET Application Number
(FILL UP THE DETAILS IN CAPITAL LETTERS)
YEAR OF ADMISSION 2016 - 2017
[ For Office use only ]
ENROLMENT No.
Affix recent
Passport size
Photograph
PROGRAMME CODE
without
NAME OF THE PROGRAMME
attestation (or)
stamped seal

MEDIUM English Tamil

I Year II Year III Year
OPTIONAL SUBJECTS (if any)

NAME OF THE APPLICANT

NAME OF THE FATHER / HUSBAND

ADDRESS

PIN

DATE OF BIRTH D D M M Y Y Y Y

QUALIFICATION
PHYSICALLY HANDICAPPED YES NO
NATIONALITY
RELIGION
COMMUNITY
PCP ZONE / CENTRE CODE
Contact Details:
Phone:
Mobile:
E-mail:
SIGNATURE OF THE APPLICANT
IN S T R U C T IO N S F O R F I L L IN G IN T H E A P P L IC A T IO N F O R M

(T h o s e w h o h a v e D o w n l o a d e d A p p li c a ti o n fr o m W e b s it e )
(i) R e a d c a r e f u l ly an d th orou g hly the A p p lic a t io n f o rm a nd th e P r o s p e ct u s
(h t tp :// a u d d e .i n / p r o s p e c tu s. p h p ) b e f o re y o u b e g i n t o fill i n t h e f o rm .
(ii) C h e ck y ou r e lig ib ilit y, i. e . m i n im u m r e q u i re d e d u ca ti o n a l q u a l ifi ca ti o n , for th e
p r o g ra m m e y o u a re a p p ly in g fo r.
(iii ) W h il e f ill in g i n th e a p p l ic a ti o n f o rm , e n te r v e r y cl e a rl y a n d co rr e c tl y t h e p ro g r a m m e
co d e , n a m e o f t h e p ro g r a m m e , m e d i u m o f i n s tr u c ti o n , o p ti o n a l s u b j e c ts a n d P C P
zo n e .
(iv ) A re c e n t P a ss p o rt siz e p h o t o g ra p h s h o u l d b e p a st e d o n th e A p p li c a ti o n F o rm a n d
sig n e d b y th e a p p lic a n t a n d a tt e st e d b y a G a ze tt e d O ff ic e r.
(v) A re ce n t P a s s p o rt siz e p h o t o g r a p h s h o u l d b e p a s te d o n th e D a t a S h e e t a n d w it h o u t
a tt e st a ti o n . O n e m o re p h o t o g ra p h s h o u ld b e a t ta ch e d se p a r a t e ly f o r Id e n ti ty c a r d .
(vi ) A tta ch a tt e s te d c o p ie s o f ce rti fic a t e s fo r th e e d u c a ti o n a l q u a li fi ca ti o n a n d a c o p y o f t h e
T r a n sf e r C e rtif ic a t e / M ig ra ti o n C e rtif ic a t e .
(vii ) A tte s t a t io n : T h e p h o t o g ra p h o n th e a p p li c a ti o n f o rm m a y b e a tt e s te d b y a n y o n e o f
th e f o ll o w i n g o ffi ci a l s:
a . G a ze tte d O ffice rs.
b . M e m b e rs o f th e S yn d ica te , A ca d e m ic C o u n cil, a n d B o a rd o f S tu d ie s o f th e A n n a m a la i
U n ive rsity.
c . T e a ch e rs in C o lle g e s a n d U n ive rsitie s.
d . G a ze tte d R a n k H e a d m a ste rs o r H e a d -M istre s se s o f G o ve rn m e n t re co g n ise d H ig h e r
S e co n d a ry o r H ig h S ch o o ls.
e . C o m m issio n e d O ffice rs o f th e D e fe n ce S e rvice s.
(vii i) If th e c e r tif ic a t e s s u b m itt e d by th e a p p lic a n t a re in a la n g u a g e oth er th a n
E n g l is h / T a m il, a n a t te st e d E n g li s h ve rsi o n o f th e c e rti fi ca te s sh o u l d a c co m p a n y th e m .
(ix ) A n a p p li c a ti o n w ill b e su m m a ri ly r e j e c te d if th e re i s a n y d i sc r e p a n c y b e tw e e n th e
m a t e ri a l p a r ti cu la rs fi ll e d i n th e a p p li ca ti o n f o rm a n d t h e s u p p o r ti n g d o c u m e n t s. T h e
n a m e o f t h e a p p lic a n t, h i s/ h e r d a t e o f b irt h a n d q u a li fi ca tio n w il l b e c o n s id e r e d a s
m a t e ri a l p a rt ic u l a r s i n th is c o n te xt .
(x) W h e re a d e g r e e i s p r e scr ib e d a s t h e b a si c q u a li fi ca tio n f o r a d m is si o n t o a p r o g r a m m e ,
o n ly th o se a p p lic a n t s w h o h a v e p a ss e d t h e q u a lif yi n g e x a m in a t io n u n d e r th e p a tt e r n
o f 1 1 + 2 + 2 y e a rs o r 1 1 + 1 + 3 ye a r s o r 1 0 + 2 + 3 y e a rs w il l b e e l ig ib le f o r a d m is si o n to t h e
p r o g ra m m e s. H o w e v e r , th o s e w h o h a v e p a s s e d t h e q u a l if y i n g e x a m i n a ti o n u n d e r
1 0 + 2 + 2 p a t te r n w ill b e c o n s i d e re d f o r a d m is s i o n to D i p l o m a a n d P .G . D i p l o m a
pr o gram m e s o nly.
(xi ) C a n d i d a t e s h a ving a d ir e c t U .G . D e gre e (w it h o u t +2 Q u a lif ic a t io n ) and
C a n d i d a t e s h a v i n g a d ir e c t P .G . D e g r e e (w it h o u t U .G . d e g r e e ) a r e n o t e l ig ib le .
(xii ) A p p l ic a n ts p o s se s sin g d e g r e e s a w a rd e d b y U n i v e rs iti e s/C o ll e g e s / I n s tit u t e s w h ic h a r e
n o t re co g n i ze d b y th e U n i v e rs it y G ra n t s C o m m i ssi o n a r e n o t e li g ib le f o r a d m i s si o n t o
th e p r o g ra m m e s o ff e r e d b y th e D i re ct o r a t e o f D is ta n ce E d u c a ti o n .
 (xii i) N o c a n d i d a te i s p e rm itt e d t o jo in o r s tu d y tw o D e g re e p ro g r a m m e s a t a tim e in t h e
D D E . H o w e ve r, st u d e n t s p u r s u i n g a d e g re e p r o g r a m m e a r e p e rm i tt e d to j o in o r stu d y
a C e r tifi c a t e / D ip lo m a /P .G .D ip lo m a p ro g r a m m e co n cu rr e n tl y. If a n y c a n d i d a t e is f o u n d
p u rs u i n g T w o D e g r e e P r o g r a m m e s sim u l ta n e o u s ly , th e D ir e ct o r a t e w ill c a n c e l t h e
a d m is si o n t o o n e o f t h e p ro g r a m m e s a t i ts d i s cr e ti o n a n d t h e fe e s r e m it te d fo r t h e
ca n c e l le d p r o g r a m m e w ill b e f o r fe it e d .
(xi v) H o w e ve r, th e U n i ve rsi ty w ill n o t b e i n a p o si ti o n t o m a k e a d ju stm e n ts if t h e re i s a n y
cla s h i n th e e x a m i n a ti o n s c h e d u l e b e tw e e n t h e tw o p ro g r a m m e s t a k e n .

S E L E C T IO N O F O P T IO N A L S
C a n d i d a te s a r e g i ve n t h e o p ti o n t o s t u d y th e L a n g u a g e P a p e r s o f th e i r c h o i c e i n
U n d e r -g ra d u a te p r o g r a m m e s. T h e r e a r e a l s o s p e ci a l is a ti o n s o r O p ti o n a l P a p e r s i n m a n y
U G a n d P G P r o g r a m m e s . I n a ll s u ch P r o g ra m m e s , th e N u m b e rs g i v e n a g a i n s t t h e
S u b j e cts (P a p e r s), s u c h a s [ 0 1 ] o r [ 0 2 ] i n d ic a t e th e C o d e n o s . o f su c h O p ti o n a l s.

C a n d i d a t e s m u s t fi ll in t h e c o rr e c t C o d e N o s . o f th e L a n g u a g e P a p e r s , G r o u p o r
P a p e r s c h o s e n b y th e m , i n t h e A p p li c a ti o n F o rm f o r a d m is s i o n .

P R O C E D U R E F O R A D M IS S IO N

1. D e g re e / P r o v i s i o n a l C e r ti fi c a te
(O ri g i n a l & P h o t o S t a t C o p y )
th th
2. M ar k S he ets 1 0 / 12
(O ri g i n a l & P h o t o S t a t C o p y )

3. T r a n s fe r C e rt ifi c a t e
(O ri g i n a l & P h o t o S t a t C o p y )

4. C o m m u n i ty C e rti fi c a te (P h o to S t a t C o p y ) e x c e p t O C

5. R e c e n t P a s s p o rt s i z e P h o to 3 n o s .

6. P re s c ri b e d F e e s

(A ) S p o t S e le c tio n
A p p l i c a n t s l iv i n g n e a r a n y o f th e S t u d y / I n fo rm a ti o n C e n t r e s n o t e d i n A n n e x u r e - I a n d
A n n e x u r e - II o f t h is p r o sp e c t u s c a n s te p i n f o r S p o t A d m i ss i o n . S e l e c t io n f o r d ir e c t
a d m is s i o n t o a ll t h e p r o g ra m m e s w il l b e m a d e a t t h e S t u d y C e n tr e s.
F o r S p ot S e le ctio n, th e c a n did a tes m u st s u bm it th e follow in g d oc u m e nts in
p e rs o n :
i. F i ll e d i n a p p l i c a t i o n a l o n g w it h a tt e s t e d p h o t o st a t c o p i e s o f C e rt if i ca t e s fo r t h e
e l i g i b l e q u a l i fi c a t i o n a n d a g e .
ii . P a s sp o r t s iz e p h o t o g ra p h p a s t e d o n t h e A p p l ic a ti o n f o rm a n d g o t a t t e st e d .
ii i. C e rt if i c a t e s in O rigin a l for th e e li g i b l e q u a li fi c a ti o n and T r a n s fe r /M i g r a t i o n
C e rt if i c a t e .
iv . C o m m u n it y C e r ti fi c a t e ( e xc e p t O C )
 v . T w o P a s sp o r t s i z e P h o t o g ra p h s . A p p l ic a n t s s h o u l d n o t si g n o n t h e p h o t o g r a p h s
a f f ix e d o n t h e D a t a S h e e t . ( I d e n t it y C a r d w i ll b e s e n d b y D i r e ct o r a t e )

vi . A D e m a n d D ra f t d r a w n i n f a vo u r o f T h e D ir e c t o r, D .D .E . , A n n a m a l a i U n i v e r s i t y f o r
th e p r e s c ri b e d f e e s (R e f e r M o d e o f P a ym e n t a n d F e e s ).
O ri g i n a l C e rt if i c a t e s w i l l b e r e t u r n e d im m e d i a te l y a f t e r v e ri fi c a ti o n . T h e T r a n sf e r
C e rt if i c a t e /M i g r a t i o n C e rt i fi c a t e w il l a ls o b e h a n d e d o v e r a f t e r a f fi x i n g a s e a l t h a t t h e
c a n d i d a t e i s a d m i tt e d d u r i n g t h e a c a d e m i c ye a r .
A ll s p o t a d m i s s i o n s w il l n e e d t o b e c o n fi rm e d b y T h e D i r e c t o r a t e c a n c e ll e d i f
fo u n d n o t e li g i b l e .

(B ) A d m is s io n th ro u g h P o s t
If t h e a p p li c a n t's p la c e i s n o t n e a r a n y o f t h e S t u d y / I n f o rm a t io n C e n t r e s , t h e fi ll e d - i n
a p p li c a t i o n m a y b e se n t t o T h e D ir e c to r, D i r e ct o r a t e o f D is t a n c e E d u c a t i o n , A n n a m a l a i
U n i v e r s it y, A n n a m a la i n a g a r 6 0 8 0 0 2 a lo n g w it h a t te s te d p h o t o s t a t c o p i e s o f

(i ) C e r ti fi c a t e s f o r t h e e li g i b l e q u a li fi c a ti o n ,

(ii ) T r a n sf e r/ M i g ra ti o n C e rt if ic a te

(ii i) C o m m u n it y C e r ti fi ca t e ( e x ce p t O C )

(i v) T w o P a s s p o r t s i z e P h o to g r a p h s . A p p li c a n t s s h o u l d n o t s i g n o n t h e p h o t o g r a p h s

a f f ix e d o n t h e D a t a S h e e t . ( I d e n t it y C a r d w i ll b e s e n d b y D i r e ct o r a t e )

S tu d e n t s s e e k i n g a d m i s si o n t h r o u g h p o st n e e d n o t e n c lo s e t h e o ri g i n a l c e r ti fi c a t e s
a n d d e m a n d d r a f t a lo n g w it h t h e a d m is s io n a p p li c a ti o n .

O n r e c e ip t o f p r o vi si o n a l a d m is s io n c a rd s , t h e y h a ve t o s e n d b y R e g is t e r e d p o st o r
C o u r ie r o r S p e e d p o s t o r p ro d u c e in p e r s o n , t h e O ri g i n a l C e r ti fi c a t e s o f

(i ) E d u c a t io n a l q u a li fi c a t io n
(i i) T r a n s fe r / M ig r a t io n C e r ti fi c a t e (f o r w h ic h a tt e st e d p h o to s ta t c o p i e s h a ve b e e n
e n c l o s e d w it h t h e a p p l ic a ti o n f o rm ) a n d a D e m a n d D r a f t d r a w n i n fa v o u r o f T h e D i r e c t o r ,
D .D .E . , A n n a m a l a i U n iv e r s i t y fo r t h e p r e s cr i b e d f e e s, o b s e r vi n g t h e g u i d e l i n e s g i ve n o n
th e M o d e o f P a ym e n t . F o r F e e d e t a i l s re f e r p a g e s 6 3 t o 6 7 .

T h e a d m i s si o n c o n f irm a ti o n , t h e s i g n e d i d e n ti t y c a r d a n d t h e o ri g i n a l c e r ti fi c a t e s
in cl u d i n g T r a n s fe r C e r ti fi c a t e /M i g ra ti o n C e r ti fi c a t e a ft e r a ff i xi n g a se a l o n t h e T C t h a t t h e
c a n d id a t e i s a d m it t e d d u r i n g t h e a c a d e m i c y e a r , w i ll b e r e tu r n e d t o t h e s t u d e n t t h r o u g h
R e g i st e re d p o s t.

If t h e c e rt if ic a t e s s u b m i tt e d b y a c a n d i d a t e a r e f o u n d t o b e b o g u s / f a k e , h i s / h e r
a d m i s s io n w i ll b e c a n c e ll e d a n d t h e fe e s r e m it t e d w il l a l s o b e f o rf e it e d .

If yo u n e e d h e lp , th e n se n d m a il a lo n g w it h m o b il e n u m b e r to

E m a il: d d e o n li n e p a ym e n ts@ ya h o o .co m