GOVERNMENT OF TAMIL NADU

DIRECTORATE OF TECHNICAL EDUCATION

TAMIL NADU ENGINEERING ADMISSION - 2023
Application for Admission to B.E/B.Tech Degree Course
Application Number: 209024

Personal Information
Name: S R ABHISHEK Name of the Parent/Guardian: RAVI S K
Communication Address: Permanent Address: 32/38, Venkatachalam Chetty Street, Triplicane , Chennai- 600 005
32/38, Venkatachalam Chetty Street, Triplicane , Chennai- 600 005
State: Tamil nadu District: Chennai
Taluk: Mylapore Communication address pincode: 600005
Native District: Tiruvallur Civic status of Native Place: Municipality
Date of Birth (DD-MM-YYYY): 05-06-2005 Gender: Male
Mother Tongue: Tamil Nationality: Indian
Nativity: Tamil nadu Religion: Hindu
Name of the Community: OC Name of the Caste: Others
Aadhar Number (optional): 755183554367

Special Reservation Information

Whether you are a candidate under quota for Eminent Sports person as per Ex-Servicemen (Only Army/Navy/ Air force services are Eligible): No
annexure-II, item No.22 of information brochure?:
No
Differently Abled Person: No Differently Abled Type: --
TFC Center for certificate verification:
University Departments Of Anna University, Chennai - CEG Campus, Sardar Patel Road, Guindy,
Chennai 600 025

Scholarship Information
Parent Occupation: Others Annual Income: 198000
Are you a First Graduate?: No Post Matric Scholarship (SC/SCA/ST/Converted Christians): No

School of Study Information

Category of School: Private Civic status of school location (+2): Municipality
Have you studied VIII to XII in Tamil Nadu?: Yes Have you studied from VI to VIII in private school under RTE and IX to XII
in Government School?:
No
Have you studied VI to XII in Government school?: No

Class Year of Passing Name of the school District State Block Category of
Govt.School

VI Std. 2017 The Hindu Senior Sec School Chennai Tamil nadu Triplicane --

VII Std. 2018 The Hindu Senior Sec School Chennai Tamil nadu Triplicane --

VIII Std. 2019 The Hindu Senior Sec School Chennai Tamil nadu Triplicane --

IX Std. 2020 The Hindu Senior Sec School Chennai Tamil nadu Triplicane --

X Std. 2021 The Hindu Senior Sec School Chennai Tamil nadu Triplicane --

XI Std. 2022 The Hindu Senior Sec School Chennai Tamil nadu Triplicane --

XII Std. 2023 The Hindu Senior Sec School Chennai Tamil nadu Triplicane --

Academic Information
Qualifying Examination: CBSE Name of the Board of Examination: Central Board of Secondary Education
Permanent register number: -- HSC Roll number: 20627418
Qualified Year: 2023 HSC Group: --
Group Code: Physics/ Chemistry/ Maths/ Optional Subject (0001) Medium of Instruction: English
HSC maximum (total) marks: 500 HSC obtained marks: 460
SSLC maximum (total) marks: 500 SSLC obtained marks: 460
Have you applied for NEET ?: No Have you applied for JEE ?: Yes
Educational Management Information System(EMIS) Number: -- Community certificate number: --
Nativity certificate number (if applicable): --
 GOVERNMENT OF TAMIL NADU
DIRECTORATE OF TECHNICAL EDUCATION
TAMIL NADU ENGINEERING ADMISSION - 2023
Application for Admission to B.E/B.Tech Degree Course
Application Number: 209024

Subjects Permanent Register Number/Roll Month Year Maximum Mark Obtained Mark
Number

Physics 20627418 March 2023 100 92

Chemistry 20627418 March 2023 100 95

Mathematics 20627418 March 2023 100 94

Optional 20627418 March 2023 100 95

 GOVERNMENT OF TAMIL NADU
DIRECTORATE OF TECHNICAL EDUCATION
TAMIL NADU ENGINEERING ADMISSION - 2023
Application for Admission to B.E/B.Tech Degree Course
Application Number: 209024

DECLARATION BY THE APPLICANT

I, S R ABHISHEK (Son / Daughter) of RAVI S K hereby solemnly declare that the information furnished and the statements given in the
application and the enclosures are true, correct and complete. I further declare that should it be found otherwise, I will be liable to forfeit my
seat and / or removal from the rolls of the Institution at whatever stage of study I may be, besides making me liable for criminal prosecution.
I am fully aware that as per the directions of the Hon'ble Supreme Court of India and Tamil Nadu Prohibition of Ragging Act 1997, Ragging
is an offence, as is banned in the Institutions and anyone indulging in ragging is liable to be punished such as expulsion from the Institutions
and / or rigorous imprisonment up to 3 years, and / or fine up to Rs.25,000/-

Place:

Date: ( Signature of the Applicant )

DECLARATION BY THE PARENT/ GUARDIAN

I, RAVI S K (Parent / Guardian) of S R ABHISHEK hereby solemnly declare that I am fully aware of the declaration made by the applicant,
and I declare and bind myself on the same terms contained in the above declaration. The statements and the information given are true, correct
and complete. If it is found otherwise, the applicant is liable to forfeit the seat and / or removal from the rolls of the Institution at whatever
may be the stage of study, besides making me liable for criminal prosecution I am fully aware that as per the directions of the Hon'ble Supreme
Court of India and Tamil Nadu Prohibition of Ragging Act 1997,Ragging is an offence, as is banned in the Institutions and anyone indulging
in ragging is liable to be punished such as expulsion from the Institution and / or rigorous imprisonment up to 3 years, and / or fine up to RS.
25,000/-

Place:

Date: ( Signature of Parent / Guardian )

Note: Guardian can execute the above declaration, only if both the parents are not alive.
 GOVERNMENT OF TAMIL NADU
DIRECTORATE OF TECHNICAL EDUCATION
TAMIL NADU ENGINEERING ADMISSION - 2023
Application for Admission to B.E/B.Tech Degree Course
Application Number: 209024

The following Certificates copy have to be uploaded to our system.

1. Transfer certificate
2. 10th Mark Sheet
3. 12th Mark Sheet
4. Income Certificate of the Parent
5. Special Reservation Form for Sports and relevant certificates
6. Special Reservation Form for Ex-Serviceman and relevant certificates
7. Special Reservation Form for Blindness & Low Vision and relevant certificates