1. Enter your name *

2. Enter your parent/guardian name *

3(a). Enter your address of communication *

3(b). Pincode*

4(a). Whatsapp Number

4(b). Mobile Number *

4(d). Email ID*

5. Date of birth*

6. Gender
MaleFemaleTransgender

7. Religion

8. Mother Tongue

9. Native Place
ChennaiOutside ChennaiOther State

10. Nationality
IndianOther Country

11. Community
OCBCBCMMBC/DNCSCSTSCA

12. Caste

13. Board of Examination
State BoardCBSEOther State

14. Medium of Study
EnglishTamilOthers

15. Name of the school

16. Registration Number *

17. Month & Year of passing *

18. Last qualifying examination *
10th12th

19. Marks

20. Height (cms)

21. Weight (kgs)

22. Blood Group

23. Choice of branches in the order of preference *
(a): Select BranchDEEE - Electrical and Electronics EngineeringDME - Mechanical EngineeringDCE - Computer Engineering
(b): Select BranchDEEE - Electrical and Electronics EngineeringDME - Mechanical EngineeringDCE - Computer Engineering

24. Aadhar Card No

26. Attachments
(i). Copy of Transfer Certificate :
(ii). Copy of 10th Marksheet :
(iii). Copy of 12th Marksheet :
(iv). Copy of Community Certificate :
(v). Passportsize Photograph :

Station

Date

I declare that the information furnished in above is true and correct to the best of my knowldge.

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