GOVERNMENT OF TAMIL NADU
DIRECTORATE OF TECHNICAL EDUCATION
TAMIL NADU ENGINEERING ADMISSIONS - 2024
Application for Admission to B.E/B.Tech Degree Course
Application Number: 334784
Personal Information
Name: Nishanth S Name of the Parent/Guardian: Sugumaran S
Communication Address: Permanent Address:
No.153/c udaiyar street opposite to sivan kovil arch nalathukudi Mayiladuthurai No.153/c udaiyar street opposite to sivan kovil arch nalathukudi Mayiladuthurai
State: Tamil nadu District: Mayiladuthurai
Taluk: Mayiladuthurai Communication address pincode: 609001
Native District: Mayiladuthurai Civic status of Native Place: Village Panchayat
Date of Birth (DD-MM-YYYY): 27-11-2003 Gender: Male
Mother Tongue: Tamil Nationality: Indian
Nativity: Tamil nadu Religion: Hindu
Name of the Community: SC Name of the Caste: Adi Dravida
Aadhar Number (optional): 386401451192
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?:
Yes
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: Agriculture Annual Income: 60000
Are you a First Graduate?: No Post Matric Scholarship (SC/SCA/ST/Converted Christians): Yes
Are you planning to avail education loan?: N
School of Study Information
Category of School: Private Civic status of school location (+2): Village Panchayat
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. 2018 Raj Matric Hr Sec School, Mayiladuthurai Mayiladuthurai Tamil nadu Mayiladudurai --
VII Std. 2019 Raj Matric Hr Sec School, Mayiladuthurai Mayiladuthurai Tamil nadu Mayiladudurai --
VIII Std. 2020 Raj Matric Hr Sec School, Mayiladuthurai Mayiladuthurai Tamil nadu Mayiladudurai --
IX Std. 2021 Raj Matric Hr Sec School, Mayiladuthurai Mayiladuthurai Tamil nadu Mayiladudurai --
X Std. 2022 Raj Matric Hr Sec School, Mayiladuthurai Mayiladuthurai Tamil nadu Mayiladudurai --
XI Std. 2023 Raj Matric Hr Sec School, Mayiladuthurai Mayiladuthurai Tamil nadu Mayiladudurai --
XII Std. 2024 Raj Matric Hr Sec School, Mayiladuthurai Mayiladuthurai Tamil nadu Mayiladudurai --
Academic Information
Qualifying Examination: TN-HSC Name of the Board of Examination: Tamil nadu Board of Higher Secondary Education
Permanent register number: XM22R0771555594 HSC Roll number: 6457541
Qualified Year: 2024 HSC Group: HSC Academic
Group Code: Physics/ Chemistry/ Maths/ Computer Science Medium of Instruction: Tamil
HSC maximum (total) marks: -- HSC obtained marks: --
SSLC maximum (total) marks: 333 SSLC obtained marks: 333
Have you applied for NEET ?: No Have you applied for JEE ?: No
Have you applied for Indian Maritime University Common Entrance Test (IMU Educational Management Information System(EMIS) Number:
CET)?: 3319070440200163
No
Community certificate number: EB7C6C7F6A687086 Nativity certificate number (if applicable): --
GOVERNMENT OF TAMIL NADU
DIRECTORATE OF TECHNICAL EDUCATION
TAMIL NADU ENGINEERING ADMISSIONS - 2024
Application for Admission to B.E/B.Tech Degree Course
Application Number: 334784
GOVERNMENT OF TAMIL NADU
DIRECTORATE OF TECHNICAL EDUCATION
TAMIL NADU ENGINEERING ADMISSIONS - 2024
Application for Admission to B.E/B.Tech Degree Course
Application Number: 334784
Affix recent Passport
size Photo
DECLARATION BY THE APPLICANT
I, NISHANTH S (Son / Daughter) of SUGUMARAN S 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, SUGUMARAN S (Parent / Guardian) of NISHANTH 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 TECHNICAL EDUCATION
TAMIL NADU ENGINEERING ADMISSIONS - 2024
Application for Admission to B.E/B.Tech Degree Course
Application Number: 334784
The following Certificates copy have to be uploaded to our system.
1. Transfer certificate
2. 10th Mark Sheet
3. 12th Mark Sheet
4. Permanent Community Certificate Card for SC (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
