SRI SA

I BH

AR

ATH C

OLLEGE OF ARTS AN

D S

CIENCE

Application No.

APPLICATION FORMU.G. DEGREE COURSE

Photo

Name : (as in SSLC / H.Sc Mark Statement)

COURSE APPLIED FOR

PART - 1 LANGUAGE Tamil Others

Father / Guardian’s Name :

Father / Guardian’s Profession :

Address for Communication :

District : Pin Code :

State : Nationality :

Phone No. : Religion :

Community : Caste :OC BC MBC SC ST(As per Tamil nadu Govt. Norms)

Gender : Date of Birth :Male Female(Date) (Month) (Year)

Hostel Accommodation Required :

Age :

Yes No

If, physically handicapped, specify the nature

Are you the son / daughter of Ex-Serviceman?

SRI SAI BHARATH COLLEGE OF ARTS & SCIENCE(Co- Education)

(Approved by Govt. of Tamil Nadu, Affi liated to Madurai Kamaraj University,Recognised by University Grants Commission Section 2 (F) UGC Act, New Delhi)

ODDANCHATRAM - VEDASANDUR HIGHWAY,NAVAMARATHUPATTY, DINDIGUL - 624 710.Ph : 04551-294433, Cell : 85080 60533, 85080 60522

www.srisaibharathcollege.com; Email : ssbcas@gmail.com

Qualifying Examination Passed : HSC or PD or Equivalent :

Month &Yearof Passing

No. ofAttempts

MaximumMarks

Marksobtained Register No.Subject

Part I : Tamil /Part II : EnglishPart III :1)2)3)4)

Total

Name of the School where studied last

Distinction in Sports / NCC / NSS / YRC

Student’s DeclarationI the undersigned, hereby declare that all the particulars given in this application are complete and

accurate to the best of my knowledge. If admitted tho the college, I agree to observe all the rules andregulations of the college and to pay all the fees and charges due to the college. If I am found, notadhering to the stipulated rules of discipline and code of conduct, I shall lose privilege of continuing asthe student of the college.

Signature of the applicant

Parent’s DeclarationI the undersigned, hereby declare that I have carefully studied the rules and regulations of the

College and that I will be responsible for all the activities of my ward. I also declare that I will remit all thedues on behalf of my ward in the college.

Signature of the Parent / GuardianPlace :

Date :

FOR OFFICE USE ONLYCertificates Verified :

10th Standard Mark SheetH.Sc / Pre - Degree Mark SheetTransfer Certificate

Community CertificateConduct CertificateOther Certificate

Signature of the Verified Staff :

Admitted in

Principal

Roll No.

Date

Admitted / Not Admitted

Application No.

APPLICATION FORMP.G. DEGREE COURSE

Photo

Name : (as in SSLC / H.Sc Mark Statement)

COURSE APPLIED FOR

Father / Guardian’s Name :

Father / Guardian’s Profession :

Address for Communication :

District : Pin Code :

State : Nationality :

Phone No. : Religion :

Community : Caste :OC BC MBC SC ST(As per Tamil nadu Govt. Norms)

Gender : Date of Birth :Male FemaleSRI S

AI B

HA

RAT

H COLLEGE OF ARTS A

ND

SCIENCE

(Date) (Month) (Year)

Hostel Accommodation Required :

Age :

Yes No

If, physically handicapped, specify the nature

Are you the son / daughter of Ex-Serviceman?

SRI SAI BHARATH COLLEGE OF ARTS & SCIENCE(Co- Education)

(Approved by Govt. of Tamil Nadu, Affi liated to Madurai Kamaraj University,Recognised by University Grants Commission Section 2 (F) UGC Act, New Delhi)

ODDANCHATRAM - VEDASANDUR HIGHWAY,NAVAMARATHUPATTY, DINDIGUL - 624 710.Ph : 04551-294433, Cell : 85080 60533, 85080 60522

www.srisaibharathcollege.com; Email : ssbcas@gmail.com

DETAILS OF QUALIFYING EXAMINATION PASSED(i) NAME OF THE DEGREE PASSED MAIN SUBJECT(ii) YEAR OF STUDY (iii) MEDIUM OF INSTRUCTION(iv) NAME AND ADDRESS

OF INSTITUTION LAST ATTENTED(v) NAME OF THE UNIVERSITY(vi) EXAMINATION PARTICULARS (Enclose attested xerox copy of mark statements)

Month & Year ofPassingRegister No.No. of

AttemptsClass

obtainedPercentage

of MarksMaximum

MarksTotal

MarksSecured

Subject

Part I Language......................................................

Part II English

(vii) Percentage Main / Core Ancy. / Allied Part III

Details of applications made for otherCourses / Colleges

Distinction in Sports / NCC / NSS / YRC

Student’s DeclarationI the undersigned, hereby declare that all the particulars given in this application are complete and accurate to the best

of my knowledge. If admitted tho the college, I agree to observe all the rules and regulations of the college and to pay all thefees and charges due to the college. If I am found, not adhering to the stipulated rules of discipline and code of conduct, I shalllose privilege of continuing as the student of the college.

Signature of the applicant

Parent’s DeclarationI the undersigned, hereby declare that I have carefully studied the rules and regulations of the College and that I will be

responsible for all the activities of my ward. I also declare that I will remit all the dues on behalf of my ward in the college.

Signature of the Parent / GuardianPlace :

Date :

FOR OFFICE USE ONLY

10th Standard Mark SheetH.Sc / Pre - Degree Mark SheetUG Marks StatementProvisional & Convocation

Transfer CertificateCommunity CertificateConduct CertificateEligibility

Admitted in

Principal

Roll No.

Date

Part III Main / Core......................................................

Ancillary / Allied I......................................................

Ancillary / Allied II......................................................

Admitted / Not AdmittedCertificates Verified :

Signature of the Verified Staff :

SRI SAI BHARATH COLLEGE OF EDUCATION(Co- Education)

(Approved by National Council of Teacher Education (NCTE), SRC / APP0010/62185 / 3-3-2015, New Delhi)ODDANCHATRAM - VEDASANDUR HIGHWAY,SULLERUMBU (POST), DINDIGUL - 624 710.Ph : 04551-294433, Cell : 85080 60533, 85080 60522

www.srisaibharathcollege.com; Email : ssbtrust@gmail.com

SRI SA

I B

HA

RA

TH COLLEGE OF EDU

CATION

Application No.

APPLICATION FORM

Photo

Name : (as in SSLC / H.Sc Mark Statement)

COURSE APPLIED FOR

Father / Guardian’s Name :

Father / Guardian’s Profession :

Address for Communication :

District : Pin Code :

State : Nationality :

Phone No. : Religion :

Community : Caste :OC BC MBC SC ST(As per Tamil nadu Govt. Norms)

Gender : Date of Birth :Male Female(Date) (Month) (Year)

Hostel Accommodation Required :

Age :

Yes No

If, physically handicapped, specify the nature

Are you the son / daughter of Ex-Serviceman?

OPTIONAL :

DETAILS OF QUALIFYING EXAMINATION PASSED( i) NAME OF THE DEGREE PASSED MAIN SUBJECT(ii) YEAR OF STUDY (iii) MEDIUM OF INSTRUCTION(iv) NAME AND ADDRESS

OF INSTITUTION LAST ATTENTED(v) NAME OF THE UNIVERSITY(vi) EXAMINATION PARTICULARS (Enclose attested xerox copy of mark statements)

Month & Year ofPassingRegister No.No. of

AttemptsClass

obtainedPercentage

of MarksMaximum

MarksTotal

MarksSecured

Subject

Part I Language......................................................

Part II English

(vii) Percentage Main / Core Ancy. / Allied Part III

Details of applications made for otherCourses / Colleges

Distinction in Sports / NCC / NSS / YRC

Student’s DeclarationI the undersigned, hereby declare that all the particulars given in this application are complete and accurate to the best

of my knowledge. If admitted tho the college, I agree to observe all the rules and regulations of the college and to pay all thefees and charges due to the college. If I am found, not adhering to the stipulated rules of discipline and code of conduct, I shalllose privilege of continuing as the student of the college.

Signature of the applicant

Parent’s DeclarationI the undersigned, hereby declare that I have carefully studied the rules and regulations of the College and that I will be

responsible for all the activities of my ward. I also declare that I will remit all the dues on behalf of my ward in the college.

Signature of the Parent / GuardianPlace :

Date :

FOR OFFICE USE ONLYCertificates Verified :

10th Standard Mark SheetH.Sc / Pre - Degree Mark SheetUG Marks StatementProvisional & Convocation

Transfer CertificateCommunity CertificateConduct CertificateEligibility

Admitted in

Signature of the Verified Staff :

Principal

Roll No.

Date

Part III Main / Core......................................................

Ancillary / Allied I......................................................

Ancillary / Allied II......................................................

Admitted / Not Admitted

SRI SAI

BH

AR

ATH

N

URSING & PARAMED

ICA

L INSTITUTE

Application No.

APPLICATION FORM

Photo

Name : (as in SSLC / H.Sc Mark Statement)

COURSE APPLIED FOR

Father / Guardian’s Name :

Father / Guardian’s Profession :

Address for Communication :

District : Pin Code :

State : Nationality :

Phone No. : Religion :

Community : Caste :OC BC MBC SC ST(As per Tamil nadu Govt. Norms)

Gender : Date of Birth :Male Female(Date) (Month) (Year)

Hostel Accommodation Required :

Age :

Yes No

If, physically handicapped, specify the nature

Are you the son / daughter of Ex-Serviceman?

DEPARTMENT :

SRI SAI BHARATH NURSING & PARAMEDICAL INSTITUTE(Affiliated to The Dr. M.G.R. Medical University, Mother Terasa Women’s University & TNOU)

ODDANCHATRAM - VEDASANDUR HIGHWAY,SULLERUMBU (POST), DINDIGUL - 624 710.Ph : 04551-294433, Cell : 85080 60533, 85080 60522

www.srisaibharathcollege.com; Email : ssbtrust@gmail.com

Qualifying Examination Passed : HSC or PD or Equivalent :

Month &Yearof Passing

No. ofAttempts

MaximumMarks

Marksobtained Register No.Subject

Part I : Tamil /Part II : EnglishPart III :1)2)3)4)

Total

Name of the School where studied last

Distinction in Sports / NCC / NSS / YRC

Student’s DeclarationI the undersigned, hereby declare that all the particulars given in this application are complete and

accurate to the best of my knowledge. If admitted tho the college, I agree to observe all the rules andregulations of the college and to pay all the fees and charges due to the college. If I am found, notadhering to the stipulated rules of discipline and code of conduct, I shall lose privilege of continuing asthe student of the college.

Signature of the applicant

Parent’s DeclarationI the undersigned, hereby declare that I have carefully studied the rules and regulations of the

College and that I will be responsible for all the activities of my ward. I also declare that I will remit all thedues on behalf of my ward in the college.

Signature of the Parent / GuardianPlace :

Date :

FOR OFFICE USE ONLYCertificates Verified :

10th Standard Mark SheetH.Sc / Pre - Degree Mark SheetTransfer Certificate

Community CertificateConduct CertificateOther Certificate

Signature of the Verified Staff :

Admitted in

Principal

Roll No.

Date

Admitted / Not Admitted