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D de Application

The application requests information such as the applicant's name, father's name, address, date of birth, community, education qualifications, and payment details. The applicant must sign declaring the information is true and attach documents including mark statements, degree certificates, photos, and a demand draft for the prescribed fee. A programme officer will review the application and original documents and indicate if the candidate is admitted or not.

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106 views2 pages

D de Application

The application requests information such as the applicant's name, father's name, address, date of birth, community, education qualifications, and payment details. The applicant must sign declaring the information is true and attach documents including mark statements, degree certificates, photos, and a demand draft for the prescribed fee. A programme officer will review the application and original documents and indicate if the candidate is admitted or not.

Uploaded by

Shyam Rathi
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Appln No.

For Office Use only

TAMIL NADU PHYSICAL EDUCATION AND SPORTS UNIVERSITY CHENNAI-600 127 DIRECTORATE OF DISTANCE EDUCATION APPLICATION FOR ADMISSION 2012 - 2013

To be filled by the Study Centre Name of the Centre Code No

: : :

AFFIX STAMP SIZE PHOTO AND TO BE ATTESTED BY A GAZETTE OFFICER

(To be filled in by the Candidate in his / her own handwriting in BLOCK Letters) Course Applied for / (Please Put mark in the appropriate box) Course for Applying Course Name

Medium of the Course :

ENGLISH

1 (a) Name of the Applicant in English (As in Qualifying Certificate in BLOCK letters)

1 (b) Name of the Applicant in (Tamil)

2. Fathers Name

3. Address for Communication .. ..

Phone with STD Code

Mobile No

4.

5. Community

SC

ST

MBC

BC

OC

6. Date of Birth

Date

Month

Year 7. Nationality _______________

8. Rural

9. Urban

9. Details of Education Qualification For Distance Education Stream Course Studied 10th Std 12th Std Name of the Degree Major Month & Year passing Name of the Insttn/ College/ University % of Marks / Class

Under Graduate (Enclose Attested Copies of Provisional Certificate or Degree Certificate. Individual Mark Statement will not be accepted) 10. Particular for Demand Draft: (For Course Fee only) DD. No ______ Amount Rs ______ Date _______________ Bank ________________________

Note: The Candidate should write his / her name on the backside of the demand draft. I hereby declare that the particulars given above are true. If any of the particulars furnished are found to be false, I agree to forfeit my admission.

Date:

Signature of the Candidate

Note: The following documents must accompany the filled in application 1. S.S. L.C. Mark Statement Attested Xerox copy. 2. HSC Mark Statement Attested Xerox Copy 3. Attested Xerox Copy of Provisional or Degree Certificate 4. Two Stamp size photos, 5. Demand Draft for prescribed fee (Refer to Prospectus)

Certified that the Application is scrutinized, the Original Certificates are verified and the candidate is found eligible

Admitted /Not Admitted Date of Admission _______________

Signature of the Programme Officer with Seal Received back the Original Certificates:

DIRECTOR, DDE, TNPESU

(Signature of the Candidate)

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