App.

Online:2024-'25

SEMESTER PATTERN
ANNAMALAI UNIVERSITY APPLICATION NO.
CENTRE FOR DISTANCE AND ONLINE EDUCATION
Annamalainagar - 608 002. 715170
Application for Admission to FOR OFFICE USE ONLY
Diploma / Certificate /Grade Certificate ENROLMENT NO.
Programme in Music and Dance
2024 - 2025

) in square q
(REFER PROSPECTUS FOR DETAILS) (Make a tick-mark (ü wherever applicable)

A RECENT
PASSPORT SIZE
1. Programme PHOTOGRAPH
Code & Name SHOULD BE PASTED
2. Medium: English q
Tamil q
AND SIGNED BY
THE APPLICANT

3. Name in CAPITAL LETTERS with Initials (in English)

4. Father's Name / Spouse Name / Guardian Name

5. ADDRESS IN CAPITAL LETTERS (to which communication and self learning study materials are to be sent)

PIN
Dist.
Phone No.
State (with STD Code)
6.E-mail ID Mobile No. :

7. Date of Birth Date Month Year

(as entered in the School Leaving Certificate) Age

8. Aadhaar Number:

9. ABC ID (See Prospectus)

10. DEB ID

11. Sex: Male q

Female qTransgender q12. Nationality:

13. Religion: Hindu qMuslim qChristian qOthers (specify)

14. Community: ST SC SCA MBC DNC OBC BC BCM OC

15. Differently Abled: YES q

NO q
Visually challenged q
Others Percentage
(specify)
16. Qualifying Examination Passed:
Name of the Duration of Name of the Reg. No. Percentage of Class
Marks/Grade
Examination Programme University/Board and Year point Obtained
Main :

Ancillary :

Application Fee ` 118/- (including GST)

17. Pattern of passing 11+2+2 q 11+1+3 q 10+2+3 q 10+2+4 q
the Degree Examination: (Direct OUS UG / PG Degree are Not Eligible)
18.Qualifying Examination Passed (Grade Certificate Programmes):

Name of the Duration of Name of the School

Examination Programme / University / Board PASS / FAIL

19. Occupation /Designation Government q

Non-Government q
Others q

20. Are you presently undergoing any

other programme in any institution Yes q
No q
(including CDOE)? If yes, give details :

DECLARATION
i) I declare that the particulars given above are correct and I submit myself to the disciplinary and regularly jurisdiction of the authorities of
the University who are vested with the rights to exercise discipline under the Act, the Statutes, and the Ordinances, and will strictly observe
the rules and regulations that have been framed thereunder by the University.
ii) I hereby agree that with regard to disputes arising in all matters including admission, returning of original certificates after verification,
sending of study materials, PCPs, response sheets, examinations, remittance of fees, etc., only the Courts and Tribunals having jurisdiction
over Annamalainagar (Chidambaram), Cuddalore District, Tamil Nadu and not over any other place, shall have jurisdiction for the purpose of
filing a suit or preferring complaint under the Consumer Protection Act or any other law for the time being in force or for taking any legal action
against the Centre for Distance and Online Education or the Controller of Examinations, Annamalai University.

Place:
Date: Signature of the Applicant

Enclosures:(1) Degree Certificate / Course completion certificate /Provisional certificate q

(5) Photostat Copy of Community Certificate q
(except OC)
(2) Photostat Copy of Mark List or Consolidated Mark List q
(6) Data Sheet duly filled in q
(3) Photostat Copy of Transfer or Migration Certificate q
(7) Copy of the Aadhaar Card q
(4) Identity Card duly filled in q
(Do not enclose original certificates)

FOR OFFICE USE ONLY ELIGIBLE q

NOT ELIGIBLE q

CERTIFICATES VERIFIED REMITTANCE PARTICULARS

1) Degree/Provisional/Course completion certificate q
Name of the Bank :
2) Transfer OR Migration/Any Certificate for Age proof q
Online/PoS Transaction No. :
3) Marksheets (10th/12th Standard) q
Amount :
4) 8th Standard Transfer Certificate q
Date : Selected
5) 10th Standard Transfer Certificate q
Centre Code : Rejected
6) Aadhaar card q
Provisionally selected for admission.

Official in-Charge Section Head

Whether Original Certificates/Marksheets Whether study materials received? Yes q No q

received after verification? Yes q
No q If yes, Complete set q Incomplete set q

Signature of the Candidate

Admission Confirmed
___________________________is hereby provisionally selected for the ______________________ Programme

Seat Assistant Section Head Co-ordinator DIRECTOR

715170
 715170
To be filled in by the candidate in his/her own
handwriting
ANNAMALAI UNIVERSITY Name:
CENTRE FOR DISTANCE AND ONLINE EDUCATION
Annamalainagar - 608 002. Address:

IDENTITY CARD
PINCODE:
Date of Birth :
Appln. No. :
Programme :
Medium : Tamil / English
Affix recently Optional :
taken passport
size photo ACADEMIC YEAR : 2024-2025
For Office Use Only
Enrolment No.

DIRECTOR
.........................
Signature of the Candidate
 click: https://audde.in/prospectus.php

Instruction for Admission

Read the prospectus carefully, before filling up the application.

Submit your filled-in application, along with necessary enclosures to the

The Director,
Centre For Distance And Online Education,
Annamalai University,
Annamalainagar – 608 002

DOCUMENTS for Admission[Original & Xerox copy]

Ⅰ. Degree / Provisional Certificate

Ⅱ. Marksheets 10th, 11th and 12th ( or 11+2+2 or 11+1+3 as the case may be)
Ⅲ. Transfer Certificate
Ⅳ. Community Certificate for BC/OBC/BCM/MBC/SC/ST
Ⅴ. Aadhaar Card
Ⅵ. Recent Passport Size Photos – 3
Ⅶ. Admission Fees (Refer Prospectus)

Originals will be returned after verification.

If the certificates submitted by a candidate are found to be bogus or fake,

his/her admission will be CANCELLED and the fees remitted will also be
forfeited.

FEE CONCESSION
Differently Abled and Visually Challenged Students Certified by Government
of Tamil Nadu are exempted from payment of Tuition Fees and Special Fees
on production of a Disability Certificate issued by the District Welfare
Officer. However, they are required to pay the other prescribed fees such
as admission fee, registration fee, eligibility fee, postage, PCP fee etc.