SRI VENKATESWARA GROUP OF INSTITUTIONS

Exclusive Institutes for world class MBA / MCA

(APPROVED BY AICTE AND AFFILIATED TO ANNA UNIVERSITY–CHENNAI)

MCA ADMISSIONS 2018– 19

(MCA – REGULAR / LATERAL)

APPLICATION FORM

NOTE: 1. All particulars should be filled-up in CAPITAL LETTERS only

2. Submit this application form to

The Director(Admissions),

SRI VENKATESWARA GROUP OF INSTITUTIONS,

Sri Venkateswara College Road, Ettimadai, Coimbatore –641 112.

1. Name(in BLOCK LETTERS) as given :

In X Std certificate

2. TANCET records: Reg. No ______

Year 201___SCORE_____

3. Gender [tick (√) the appropriate box] MALE / FEMALE

4. Nationality:

D / D / M / M / Y / Y / Y / Y

5. Date of Birth (Attach photocopy of the

X Std mark sheet for age proof) & Age :

6. Place of Birth:

7. Religion :

8. Social Status : OC/OBC / BC / MBC /SC/ST

9. Marital Status :

(Write ‘M’ for Married/ ‘S’ for Single)

10. Mother Tongue / languages known :

11. Details of Parents

Father’s Name: ______

Mother’s Name: ______

Occupation: ______

Designation: ______

Phone/ Mobile Number: ______

Email Id: ______

Annual Income (Rs): ______

  1. No. of Brothers/Sisters

Brothers Status:

Sisters Status:

13Postal Address for Communication Permanent Address

(IN BLOCK LETTERS): (IN BLOCK LETTERS)

……………………………………… ……………………………………….... ……………………………………… …………………………………………

……………………………………… ………………………………………… ……………………………………… …………………………………………..

……………………………………… …………………………………………. PIN - …..…………………………… PIN - ……………………………………

State: State:

Email :

Telephone (with STD Code) :

Mobile Number:

14Qualifying Examination Details :

UG Degree with specialization:

EXAMINATION / NAME OF SCHOOL/
COLLEGE / UNIVERSITY/BOARD OF EXAMINATION / MEDIUM OF INSTRUCTION / MONTH & YEAR OF PASSING / % OF MARKS
SSLC OR EQUIVALENT
HSC OR EQUIVALENT
UG DEGREE
(Specify Branch)

15. No of years of Experience if any :

a) Teaching: Yrs b) Industry : Yrs (attach experience certificate if any)

16 Physically Challenged : Yes/No (If Yes, furnish details)

______

17. Extra-Curricular Activities (SPORTS,NCC,MUSIC,NSS,etc.,)

S.No / EVENT/ACTIVITY / DETAILS/LEVEL COMPETITION / PRIZES/MEDALS WON

18.Hostel Required :Yes/No

19.Bus Facility Required :Yes /No

20.Details of Application fees paid :

i) Cost of Application : Rs. 500

(DD should be drawn in favour of “ Sri Venkateswara College of Computer Applications and Management“ payable at Coimbatore.)

iii) DD No and Date of purchase :

iv) Name of the Bank :

v) Branch :

DECLARATION

I hereby declare that I have carefully read the instructions and particulars furnished by me and the entries in this application form are correct to the best of my knowledge and belief. I note that the decision of the College is final with regard to selection for admission. If selected for admission, I promise to abide by the rules and regulations of the College and the guidelines.

Place : Signature :

Date : Name of the Applicant :

I have fully read the information furnished by my son/daughter/ward and affirm that it is true.

Place : Signature :

Date : Name of the Parent /Guardian :