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: 346744
Personal Information
Name: GOKULAKRISHNAN R Name of the Parent/Guardian: RADHAKRISHNAN G
Communication Address: 119,PILLAIYAR KOVIL THERU, Permanent Address: 119,PILLAIYAR KOVIL THERU,
SU.POLAKUNAM, SU.POLAKUNAM,
TIRUVANNAMALAI, TIRUVANNAMALAI,
606755. 606755.
State: Tamil nadu District: Tiruvannamalai
Taluk: Kilpennathur Communication address pincode: 606755
Native District: Tiruvannamalai Civic status of Native Place: Village Panchayat
Date of Birth (DD-MM-YYYY): 13-06-2006 Gender: Male
Mother Tongue: Tamil Nationality: Indian
Nativity: Tamil nadu Religion: Hindu
Name of the Community: BC Name of the Caste: Agamudayar including Thozhu or Thuluva Vellala
Aadhar Number (optional): 587612337651
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 College Of Engineering, Arni, Arni To Devikapuram Road, Thatchur, Arni, Thiruvan-
namalai - 632326
Scholarship Information
Parent Occupation: Agriculture Annual Income: 72000
Are you a First Graduate?: No Post Matric Scholarship (SC/SCA/ST/Converted Christians): No
School of Study Information
Category of School: State Govt Civic status of school location (+2): Town 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. 2017 Annaamalai Matric Hr Sec School So Tiruvannamalai Tamil nadu Kilpennathur --
Pudhur
VII Std. 2018 Annaamalai Matric Hr Sec School So Tiruvannamalai Tamil nadu Kilpennathur --
Pudhur
VIII Std. 2019 Annaamalai Matric Hr Sec School So Tiruvannamalai Tamil nadu Kilpennathur --
Pudhur
IX Std. 2020 Annaamalai Matric Hr Sec School So Tiruvannamalai Tamil nadu Kilpennathur --
Pudhur
X Std. 2021 Annaamalai Matric Hr Sec School So Tiruvannamalai Tamil nadu Kilpennathur --
Pudhur
XI Std. 2022 Annaamalai Matric Hr Sec School So Tiruvannamalai Tamil nadu Kilpennathur --
Pudhur
XII Std. 2023 Annaamalai Matric Hr Sec School So Tiruvannamalai Tamil nadu Kilpennathur --
Pudhur
Academic Information
Qualifying Examination: HSC Name of the Board of Examination: Tamil nadu Board of Higher Secondary Education
Permanent register number: -- HSC Roll number: 7672184
Qualified Year: 2023 HSC Group: HSC Academic
Group Code: Physics/ Chemistry/ Maths/ Computer Science Medium of Instruction: English
HSC maximum (total) marks: 600 HSC obtained marks: 500
SSLC maximum (total) marks: 500 SSLC obtained marks: --
Have you applied for NEET ?: No Have you applied for JEE ?: No
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: 346744
Educational Management Information System(EMIS) Number: 2000534789 Community certificate number: 5202102044022
Nativity certificate number (if applicable): 320230515457
Subjects Permanent Register Number/Roll Month Year Maximum Mark Obtained Mark
Number
Physics -- March 2023 100 69
Chemistry -- March 2023 100 82
Mathematics -- March 2023 100 70
Optional -- March 2023 100 100
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: 346744
DECLARATION BY THE APPLICANT
I, GOKULAKRISHNAN R (Son / Daughter) of RADHAKRISHNAN G 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, RADHAKRISHNAN G (Parent / Guardian) of GOKULAKRISHNAN R 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: 346744
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 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
