GOVERNMENT OF TAMIL NADU

DIRECTORATE OF COLLEGIATE EDUCATION

TAMIL NADU GOVT ARTS AND SCIENCE COLLEGES ADMISSION - 2023
Application for Admission to Arts and Science Degree Course
Application Number: 797396

Personal Information
Name: ESHWAR S Name of the Parent/Guardian: SELVAM R
Communication Address: 5/71 MEL MUTHAPALAYAM AYYUR AGARAM, Permanent Address: 5/71 MEL MUTHAPALAYAM AYYUR AGARAM,
VILLUPURAM-605601 VILLUPURAM-605601
Alternate mobile number: 6385001456 State: Tamil nadu
District: Viluppuram Taluk: Vikravandi
Communication address pincode: 605601 Native District: Viluppuram
Civic status of Native Place: Village Panchayat Date of Birth (DD-MM-YYYY): 19-03-2006
Gender: Male Mother Tongue: Tamil
Nationality: Indian Religion: Hindu
Name of the Community: BC Name of the Caste:
Kammalar or Viswakarma , Viswakarmala (including Thattar, Porkollar, Kannar, Karumar, Kollar,
Thacher, Kal Thacher, Kamsala and Viswa brahmin.)
Aadhar Number (optional): 744769287220

Special Reservation Information

Whether you are a candidate under quota for Eminent Sports person?: No Level of Participation: --
Ex-Servicemen (Only Army/Navy/ Air force services are Eligible): No Differently Abled Person: No
Differently Abled Type: -- NCC (A) Certificate Holder: No
Tamil Origin from Andaman & Nicobar Island: No Select Children/Widows of eligible Personnel of Security Forces Category:
None of the Above

Scholarship Information
Parent Occupation: Self Employed Annual Income: 25000
Are you a First Graduate?: Yes Post Matric Scholarship (SC/SCA/ST/Converted Christians): No

School of Study Information

Category of School: State Govt Civic status of school location (+2): Municipality
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 St Xavier Matriculation School Villupu- Viluppuram Tamil nadu Viluppuram --
ram

VII Std. 2018 St Xavier Matriculation School Villupu- Viluppuram Tamil nadu Viluppuram --
ram

VIII Std. 2019 St Xavier Matriculation School Villupu- Viluppuram Tamil nadu Viluppuram --
ram

IX Std. 2020 St Xavier Matriculation School Villupu- Viluppuram Tamil nadu Viluppuram --
ram

X Std. 2021 St Xavier Matriculation School Villupu- Viluppuram Tamil nadu Viluppuram --
ram

XI Std. 2022 thiru kamaraj municipal higher secondary Viluppuram Tamil nadu Viluppuram --
school villupuram

XII Std. 2023 thiru kamaraj municipal higher secondary Viluppuram Tamil nadu Viluppuram --
school villupuram

Academic Information
Qualifying Examination: HSC Name of the Board of Examination: Tamil nadu Board of Higher Secondary Education
Permanent register number: 221258585 HSC Roll number: 7592480
Qualified Year: 2023 HSC Group: HSC Academic
Group Code: PHYSICS/CHEMISTRY/COMPUTER SCIENCE/MATHEMATICS Medium of Instruction: English
Educational Management Information System(EMIS) Number: 2006765417 Community certificate number: TN52021020510401
 GOVERNMENT OF TAMIL NADU
DIRECTORATE OF COLLEGIATE EDUCATION
TAMIL NADU GOVT ARTS AND SCIENCE COLLEGES ADMISSION - 2023
Application for Admission to Arts and Science Degree Course
Application Number: 797396

Subjects Permanent Register Number/Roll Month Year Maximum Mark Obtained Mark No. of Attempts
Number

TAMIL 7592480 March 2023 100 42 1

ENGLISH 7592480 March 2023 100 43 1

PHYSICS 7592480 March 2023 100 45 1

CHEMISTRY 7592480 March 2023 100 60 1

COMPUTER SCIENCE 7592480 March 2023 100 60 1

MATHEMATICS 7592480 March 2023 100 41 1

 GOVERNMENT OF TAMIL NADU
DIRECTORATE OF COLLEGIATE EDUCATION
TAMIL NADU GOVT ARTS AND SCIENCE COLLEGES ADMISSION - 2023
Application for Admission to Arts and Science Degree Course
Application Number: 797396

Affix recent Passport

size Photo

DECLARATION BY THE APPLICANT

I, ESHWAR S (Son / Daughter) of SELVAM R 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, SELVAM R (Parent / Guardian) of ESHWAR S 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 COLLEGIATE EDUCATION
TAMIL NADU GOVT ARTS AND SCIENCE COLLEGES ADMISSION - 2023
Application for Admission to Arts and Science Degree Course
Application Number: 797396

The following original certificates have to be produced at the time of certificate verification.

1. Transfer certificate
2. 10th Mark Sheet
3. 12th Mark Sheet
4. Permanent Community Certificate Card for BC (Permanent card / Electronic form / Digitally Signed E-Certificate)
5. Income Certificate of the Parent
6. Special Reservation Form for Sports and relevant certificates
7. Special Reservation Form for Ex-Serviceman and relevant certificates
8. Special Reservation Form for Blindness & Low Vision and relevant certificates
9. Special Reservation Form for NCC-'A' Certificate holders and relevant Certificates

Printout of the application, Signed declaration and photocopies of all the above mentioned certificates need to be submitted
at the time of Admission
 GOVERNMENT OF TAMIL NADU
DIRECTORATE OF COLLEGIATE EDUCATION
TAMIL NADU GOVT ARTS AND SCIENCE COLLEGES ADMISSION - 2023
Application for Admission to Arts and Science Degree Course
Application Number: 797396

Choices Selected
District Course Id Course Name College Name College Code Preference Or-
der

Viluppuram SCSE1 B.Sc. Computer Science (E/M) ( Arignar Anna Government Arts College, Villupuram-605 602 1081008 1
1ST SHIFT )

Viluppuram SCSE2 B.Sc. Computer Science (E/M) ( Arignar Anna Government Arts College, Villupuram-605 602 1081008 2
2ND SHIFT )

Viluppuram SCSE1 B.Sc. Computer Science (E/M) ( Government Arts and Science College, Gingee-604202 1081028 3
1ST SHIFT )

Viluppuram SCSE1 B.Sc. Computer Science (E/M) ( Government Arts and Science College, Thiruvennainallur - 607 203 1081019 4
1ST SHIFT )

Viluppuram SCSE1 B.Sc. Computer Science (E/M) ( Thiru. A. Govindasamy Government Arts College, Tindivanam-604 307 1081010 5
1ST SHIFT )

Viluppuram SCSE2 B.Sc. Computer Science (E/M) ( Thiru. A. Govindasamy Government Arts College, Tindivanam-604 307 1081010 6
2ND SHIFT )

Viluppuram SCSE1 B.Sc. Computer Science (E/M) Government Arts and Science College, Thiruchitrambalam Koot Road,Va- 1081026 7
( 1ST SHIFT ) nur, Villupuram - 605111

Viluppuram SCAE1 B.C.A. Bachelor of Computer Arignar Anna Government Arts College, Villupuram-605 602 1081008 8
Application (E/M) ( 1ST SHIFT
)