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njh. Ng. vz;. 0462 - 2321614
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Manonmaniam Sundaranar
University,
Tirunelveli - 627 012
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Directorate of Distance and
Continuing Education
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Student Identity Card
1. ngah;/ Name
2. je;ij ngah; / Father's Name
3. jha; ngah; / Mother's Name
4. gpwe;j Njjp / Date of Birth
5. Kfthp / Address
:
:
:
6. Nrh;f;if vz; / Enrol.No.
7. ikak; / Centre
8. tFg;G / Class
9. ghlk; kw;Wk; gphpT / Subject
:
:
:
:
ADDRESS SLIP
(To be filled in by the applicant and returned with the admission form)
Nrh;f;if vz; / Enrol. No.
Nrh;f;if vz; / Enrol. No.
ngWeh;:
ngWeh;:
To
To
Phone / Cell :
Phone / Cell :
Pin code
Nrh;f;if vz; / Enrol. No.
Pin code
Nrh;f;if vz; / Enrol. No.
ngWeh;:
ngWeh;:
To
To
Phone / Cell :
Phone / Cell :
Pin code
Nrh;f;if vz; / Enrol. No.
Pin code
Nrh;f;if vz; / Enrol. No.
ngWeh;:
ngWeh;:
To
To
Phone / Cell :
Phone / Cell :
Pin code
Nrh;f;if vz; / Enrol. No..
Pin code
Nrh;f;if vz; / Enrol. No..
ngWeh;:
ngWeh;:
To
To
Phone / Cell :
Phone / Cell :
Pin code
Pin code
kNdhd;kzpak; Re;judhh; gy;fiyf;fofk;
jpUney;Ntyp - 627 012
MANONMANIAM SUNDARANAR UNIVERSITY,
Course Code
TIRUNELVELI, TAMILNADU
DIRECTORATE OF DISTANCE & CONTINUING EDUCATION
Application for Admission
Enrolment No.
(For Office use only)
Name of the Course / Subject Medium
Study Centre with code
Affix a passport size
photograph duly
signed by the
candidate at the top
and attested by a
Gazetted Officer at the
botttom
Address to which Communication is to be sent
(BLOCK LETTERS) (Residential address)
Name :
Address :
....................................................................................................
....................................................................................................
....................................................................................................
...................................................................................................
Phone No. / Cell :
(with code)
Pin Code
e-mail ID:
1. NAME OF THE APPLICANT
(IN BLOCK LETTERS)
2. Name of the Father
3. Name of the Mother
4. Date of Birth & Age
5. Male / Female / Transgender
5. Community OC/BC/MBC/SC/ST
6. (a) Nationality
7. College previously studied,
Course and Year of Study
(b) Mother Tongue
8. Qualifying Examinations
Examination Passed
Reg. No.
Month & Year
of Passing
Subject
Percentage
of Marks
Name of the
University / Board
No.
Date
9. Enclosures attached
Number
Date
1. Details of Payment of Fee
Demand Draft / Challan for
Admission Fee
2. Statement of Marks
3. Transfer Certificate
4. Provisional Certificate /Diploma
I hereby declare that the particulars given above are correct and that I will, if admitted, abide by the rules
and regulations of the University.
Station :
Date :
Signature of the Applicant
For Information Centre :
All the originals mentioned above are verified carefully and returned to the student. It is also certified
that the genuinity of the Original Certificates are verified by me. Xerox Copies of the originals including
Qualifying Certificate and Transfer Certificate are verified and signed by me. The Student has been instructed
to produce the originals whenever demanded by the University. The Information Centre is responsible for any
lapse in this regard.
Signature of the Co-ordinator with seal
The above Original Certificates received after verification
Signature of the Candidate
For DD&CE Office use only:
The Applicant is admitted provisionally to the First / Second / Third year of the _________ Course in the
Admission
Academic Year / Calendar Year _____________________
in Tamil / English Medium. He has
paid fee of Rs. ____________________________ at the time of Admission.
D.D. No. /.Challan No.: ___________________
Date : ______________________________
Name of the Bank
Place of Bank / Branch : _______________
: ____________________
Asst.
Remarks if any
Supdt. / Sr. Supdt.
A.R. / D.R.
Director
