SIR THEAGARAYA COLLEGE
CHENNAI – 600 021
APPLICATION FORM FOR ADMISSION TO UNDERGRADUATE COURSES
B.A., B.Sc., B.Com.,
Medium of Instruction: ENGLISH
YEAR: 2021-2022
Select Course:
- Select Course -
B.A
B.Sc.
B.com
Select Subject:
Historical Studies
Economics
Mathematics
Physics
Chemistry
Plant Biology & Plant Bio Technology
Advanced Zoology & Bio Technology
General
Name in English :
Aadhaar No. of the Candidate:
Upload Your Aadhaar Card:
Date of Birth:
Nationality:
Religion :
Community:
- Select Community -
OC
BC
BC(M)
MBC
SC
SC(A)
ST
DNC
Upload Your Community Certificate:
Caste :
Sex:
- Select Sex -
Male
Female
Transgender
Name of Father:
Name of Mother:
Mother Tongue:
Father’s / Mother’s Mobile No.:
Name of Guardian:
Guardian’s Mobile No.:
Occupation of the Parent:
Annual Income:
Address for Communication:
Student’s Mobile No.:
Email ID:
Blood Group:
- Select Blood Group -
A+
A-
B+
B-
O+
O-
AB+
AB-
Parents’s Mobile No.:
Parents’s Email ID:
Are you Physically Handicapped?
(if Yes, Enclose Certificate)
Yes
No
Are you the Son / Daughter of Ex-Serviceman of Tamilnadu Origin?
(if yes, Attach Proof)
Yes
No
Distinctions in Sports / NCC / NSS / YRC
(if yes, Attach Proof)
Yes
No
Are you a Tamil Origin from Andaman & Nicobar Islands
(if yes, Attach Proof)
Yes
No
Name & Address of the School last studied:
Any Break in Studies?
(if Yes, State reason for the break)
Yes
No
Have you received any Scholarship earlier?
(if yes, give details)
Yes
No
Examination Passed :
H.S.C or Equivalent ( Must enclose Photo Copies of the Mark Sheets)
Register Number:
Subject
Allied Subject
Maximum
Marks
Marks
Secured
Month &
Year of Passing
No.
of Attempts
%
of Marks
Part I : Tamil / Telugu
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
1
2
3
Part II : English
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
1
2
3
Part III : 1
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
1
2
3
Part III : 2
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
1
2
3
Part III : 3
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
1
2
3
Part III : 4
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
1
2
3
Total
Marks Secured in
Part III out of 400
% Marks Secured in
Part III out of 400
Attach Mark Sheet:
DECLARATION BY THE APPLICANT
I declare that the particulars given above are true and correct to the best of my knowledge and belief. I have read the prospectus of the college thoroughly and I affirm that I will strictly abide by all the Rules & Regulations of the college, if admitted. Also, I will not indulge in any form of RAGGING which is prohibited according to the Tamil Nadu Prohibition of Ragging Act No. 7 of 1997.
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