ghujpjhrd; gy;fiyf;fofk; tpz;zg;gg; got vz;

Application Form No.

jpUr;rpuhg;gs;sp – 620 024
Online Payment / DD
BHARATHIDASAN UNIVERSITY, Tiruchirappalli – 620 024 Particulars
SBI Collect Ref. No. :
tpz;zg;gg; gotk; / APPLICATION FORM (OR) DD Number :
,sepiy / KJepiyg; gl;lk; (,uz;L & K:d;W Mz;Lfs;) / KJepiyg; gl;lak; - fy;tpj; jpl;lq;fs; Place of Bank :
Date :
UG / POST-GRADUATE (TWO & THREE YEARS) / P.G. DIPLOMA PROGRAMMES Amount : Rs. 355/-
(Rs. 175/- for SC/ST Applicant)

tptuq;fs; midj;Jk; jkpH; my;yJ Mq;fpyj;jpy; (bgupa vGj;Jf;fspy;) epug;gg;gl ntz;Lk;

Fill up all particulars in Tamil or English (BLOCK LETTERS) ,
bghUj;jkhd fl;lj;jpy; (√) Fwp ,lt[k; / Put (√) mark in appropriate box

tpz;zg;gpf;f tpUk;g[k; fy;tpj;jpl;lKk; ghlKk; :

Programme & subject applied for
tpz;zg;gjhuh;
ifbahg;gkpl;l
gapw;W bkhHp/ Medium of Instruction : jkpH; / Tamil Mq;fpyk; / English gh];nghh;l; mst[
epHw;glj;ij ,q;nf
Ke;ija gl;lg;gog;ig g[{h;j;jp bra;jth; Kot[fSf;fhf fhj;jpUg;gth; xl;lt[k;
Completed the previous degree Awaiting results
Affix passport size
photograph duly signed
I. jd; tptuk; / PERSONAL DATA by the applicant
1. tpz;zg;gjhuupd; bgah; (khw;Wr; rhd;wpjH; & gj;jhk; tFg;g[ kjpg;bgz; gl;oaypy; cs;sgo)
Name of the Applicant (as in the Transfer Certificate & SSLC Mark Statement)

2. bgw;nwhh; / ghJfhg;ghsh; bgah; (khw;Wr; rhd;wpjH; / gj;jhk; tFg;g[ kjpg;bgz; gl;oaypy; cs;sgo)
Name of the Parent / Guardian (as in the Transfer Certificate / SSLC Mark Statement)

3. gpwe;j njjp DD MM YY 4. ghypdk; : Mz; bgz; jpUeq;if

Date of Birth Gender Male Female Transgender

5. ,dtif (rhd;wpjH; ,izf;fg;gl ntz;Lk;) 6. kjk;

Communal Category (Certificate to be attached) Religion
OC BC BC MBC SC SC ST
Muslim Arunthathiar

7. ePq;fs; fPH;fz;l VnjDk; xU tifapidr; nrh;e;jtuh ? Mk; ,y;iy

Do you belong to any one of the following categories? Yes No.
Xa;t[ bgw;w giltPuh; / Xa;t[ bgw;w giltPuupd; kfd;(s;) / khw;Wj; jpwDilnahh; (rhd;wpjH; ,izf;fg;gl ntz;Lk;)
Ex-Serviceman / son or daughter of Ex-Serviceman / Otherwise abled (Certificate to be attached)

8. brhe;j khepyk; / ehL State / Country belonging to

jkpH;ehl;lth; gpw khepyj;jth; may; ehl;lth;
Tamil Nadu Other State Foreigner

9. bjhlh;g[f;fhd Kftup (bjhiyngrp vz; kw;Wk; kpd;dQ;ry; Kftupa[ld;)

Address for Communication (with telephone no. & e-mail id.)

10. (Aadhar No.)

II. fy;tp tptuKk; njh;r;rp epiya[k; Details of Academic Record & Performance
Name of the Month and year Month and year College and Semester / Non- Choice Based
Programme last Subject of admission of completion University semester Credit System
studied (3 years studied (Yes / No) *
Programme)

(*) If yes, attested mark statements should be attached, if only grades and no marks are provided in the grade sheets.
Marks Maximum Month & No. of
Semester Titles of Major and allied courses only obtained marks Year of attempts
/ Year Passing

bkhj;j kjpg;bgz;fs; / Total Marks

,lk; & ehs; :

Place & Date tpz;zg;gjhuupd; ifbahg;gk;
Signature of the applicant
,izg;g[fspd; gl;oay; / List of enclosures
bghUj;jkhd fl;lj;jpy; (√) Fwp ,lt[k; / Put (√) mark in appropriate box

Sl. No. Item Yes No

U:.355/- f;fhd nfl;g[ tiunthiy
1 (jhH;j;jg;gl;l kw;Wk; gHq;Fo ,d tpz;zg;gjhuh;fSf;F U: 175/- kl;Lk;)
Demand Draft for Rs. 355/‐
(Rs. 175/‐ only for applicants from SC/ST category)
gj;jhk; tFg;g[ kjpg;bgz; gl;oaypd; rhd;wspf;fg;gl;l efy;
2 Attested copy of SSLC Mark Statement
khw;Wr; rhd;wpjHpd; rhd;wspf;fg;gl;l efy;
3 Attested copy of Transfer Certificate
rhjpr; rhd;wpjHpd; rhd;wspf;fg;gl;l efy;
4 Attested copy of Community Certificate
Kd;dhs; giltPuh; / Kd;dhs; giltPuupd; kfd;(s;) rhd;wpjHpd;
5 rhd;wspf;fg;gl;l efy;
Attested copy of Ex‐Serviceman / Son or daughter of Ex‐Serviceman Certificate
khw;Wj; jpwDilnahUf;fhd rhd;wpjHpd; rhd;wspf;fg;gl;l efy;
6 Attested copy of Certificate for otherwise-abled
midj;J kjpg;bgz; gl;oay;fspd; rhd;wspf;fg;gl;l efy;fs;
7 Attested copies of all Mark Statements
midj;J kjpg;bgz; gl;oay;fspd; rhd;wspf;fg;gl;l efy;fs; (tpUg;gj;
8 bjupt[ Kiwapy; gapy;gtUf;F kl;Lk; )
Attested copies of mark statements (for students studying under CBCS pattern, if
the credits alone are mentioned in the grade sheet).
 ghujpjhrd; gy;fiyf;fofk; tpz;zg;gg; got vz;.
jpUr;rpuhg;gs;sp – 620 024 Application Form No.

BHARATHIDASAN UNIVERSITY, Tiruchirappalli – 620 024

tpz;zg;gjhuupd; milahsg; gotk; / APPLICANT IDENTITY FORM *
KJepiyg; gl;lk; (,uz;L & K:d;W Mz;Lfs;) / KJepiyg; gl;lak; - fy;tpj; jpl;lq;fs;
POST-GRADUATE (TWO & THREE YEARS) / P.G. DIPLOMA PROGRAMMES

* ,g;gotj;ij tpz;zg;gg; gotj;Jld; mDg;g ntz;lhk;

Do not send this along with the application form

tptuq;fs; midj;Jk;; jkpH; my;yJ Mq;fpyj;jpy; (bgupa vGj;Jf;fspy;) epug;gg;gl ntz;Lk;

Fill up all particulars in Tamil or English (BLOCK LETTERS)
bghUj;jkhd fl;lj;jpy; (√) Fwp ,lt[k; / Put (√) mark in appropriate box

tpz;zg;gpf;f tpUk;g[k; fy;tpj;jpl;lKk; ghlKk; :

Programme & Subject applied for

tpz;zg;gjhuh;
1. tpz;zg;gjhuupd; bgah; (khw;Wr; rhd;wpjH; & gj;jhk; tFg;g[ kjpg;bgz; gl;oaypy; cs;sgo) ifbahg;gkpl;l
Name of the Applicant (as in Transfer Certificate & SSLC Mark Statement) gh];nghh;l; mst[
epHw;glj;ij ,q;nf
xl;lt[k;
Affix passport size
2. bgw;nwhh; / ghJfhg;ghsh; bgah; (khw;Wr; rhd;wpjH; & gj;jhk; tFg;g[ photograph duly signed
kjpg;bgz; gl;oaypy; cs;sgo) by the applicant
Name of the Parent / Guardian (as in Transfer Certificate & SSLC Mark Statement)

3. bjhlh;g[f;fhd Kftup (bjhiyngrp vz; kw;Wk; kpd;dQ;ry; Kftupa[ld;)

Address for Communication (with telephone no. & e-mail id.)

Fwpg;g[
Note
g[{h;j;jp bra;ag;gl;l ,e;j gotj;ij EiHt[j; njh;t[ / neh;Kfj; njh;t[ / nrh;f;ifapd; nghJ fz;og;ghf
bfhz;L tu ntz;Lk;.
This duly filled‐in form should be produced compulsorily at the time of entrance test / interview/ admission

,lk; :
Station tpz;zg;gjhuupd; ifbahg;gk;
Signature of the applicant
ehs; :
Date