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Cform

This document is an examination application form for a grace chance in April 2010 from the Government of Tamil Nadu's Department of Technical Education. It requests information from candidates such as registration number, name, date of birth, institution details, and marks obtained in previous semesters. Candidates must provide details of subjects passed, failed subjects as per the scheme of study, and internal marks secured. They must declare that the information is true and they will only be awarded a diploma upon passing all subjects.

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Ramachandran Rajaram
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12 views

Cform

This document is an examination application form for a grace chance in April 2010 from the Government of Tamil Nadu's Department of Technical Education. It requests information from candidates such as registration number, name, date of birth, institution details, and marks obtained in previous semesters. Candidates must provide details of subjects passed, failed subjects as per the scheme of study, and internal marks secured. They must declare that the information is true and they will only be awarded a diploma upon passing all subjects.

Uploaded by

Ramachandran Rajaram
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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GOVERNMENT OF TAMIL NADU DEPARTMENT OF TECHNICAL EDUCATION, BOARD OF EXAMINATIONS, CHENNAI 25 EXAMINATION APPLICATION FORM (GRACE CHANCE) APRIL

L 2010
Reg No Scheme of Study Full Time Part Time Sandwich Private Name of the Candidate If joined in second year (lateral entry) HSC (A) HSC (V) Institution Code Branch

Sex Male Female

Date of Birth

Details of Last Appearance


Reg No Month & Year

Address for Communication

Affix Passport Size Photo (to be attested by the Head of the Institution)

Contact Phone / Mobile No(s) DETAILS OF FIRST APPEARANCE


First Year Reg No II Semester III Semester IV Semester V Semester VI Semester VII Semester VIII Semester

Month & Year

Scheme Total No. of Subjects

DETAILS OF YEAR / SEMESTERS COMPLETELY PASSED


First Year Reg No II Semester III Semester IV Semester V Semester VI Semester VII Semester VIII Semester

Month & Year

MARKS SCORED IN SUBJECTS ALREADY PASSED

(fill up the details only for passed subjects, enclose attested copy of mark certificates with marks)
Col No First Year IM EM Total IM III Semester EM Total IM IV Semester EM Total IM V Semester EM Total

10

11 Col No VI Semester IM EM Total IM VII Semester EM Total IM VIII Semester EM Total IM EM Total

DETAILS OF ARREAR SUBJECTS


As per Scheme of Study Year / Semester Col No Name of the Subject Year / Semester As per J Scheme Equivalence Col No Name of the Subject Internal Marks Secured

I hereby declare that The information furnished in this application is true, correct and complete. I am appearing for all failed subjects. I will be awarded Dipoma only on application with proof of passing all subjects (with marks). I am fully aware that this is a special scheme announced by the Government for writing the examination to the candidates (who have exhausted their chances) to complete the Diploma in three attempts (January 2009, October 2009 and April 2010) I will not claim any more chances for writing the Examination in future. I am aware that incomplete applications & applications without proper enclosures will be summarily rejected.

Countersigned

Signature of the Head of the Institution with Seal

Signature of the Student with Date

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