ghujpjhrd; gy;fiyf;fofk; jpUr;rpuhg;gs;sp 620 024

BHARATHIDASAN UNIVERSITY, Tiruchirappalli 620 024

tpz;zg;gg; gotk; / APPLICATION 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

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

gapw;W bkhHp/ Medium of Instruction : jkpH; / Tamil Mq;fpyk; / English

Ke;ija gl;lg;gog;ig g[{h;j;jp bra;jth; Kot[fSf;fhf fhj;jpUg;gth;

Completed the previous degree Awaiting results

I. jd; tptuk; / PERSONAL DATA

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 Muslim

MBC SC SC Arunthathiar

ST

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.)

tpz;zg;gg; got vz; Application Form No.

tpz;zg;gjhuh;

ifbahg;gkpl;l

gh];nghh;l; mst[

epHw;glj;ij ,q;nf

xl;lt[k;

Affix passport size photograph duly signed

by the applicant

Online Payment / DD Particulars SBI Collect Ref. No. : (OR) DD Number : Place of Bank : Date : Amount : Rs. 300/- (Rs. 150/- for SC/ST Applicant)

II. fy;tp tptuKk; njh;r;rp epiya[k; Details of Academic Record & Performance

Name of the Programme last studied (3 years

Programme)

Subject

Month and year of admission

Month and year of completion

College and University

studied

Semester / Non-semester

Choice Based Credit System (Yes / No) *

(*) If yes, attested mark statements should be attached, if only grades and no marks are provided in the grade sheets.

Semester / Year

Titles of Major and allied courses only

Marks obtained

Maximum marks

Month & Year of Passing

No. of attempts

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

1

U:.300/- f;fhd nfl;g[ tiunthiy

(jhH;j;jg;gl;l kw;Wk; gHq;Fo ,d tpz;zg;gjhuh;fSf;F U: 150/- kl;Lk;)

Demand Draft for Rs. 300/ (Rs. 150/ only for applicants from SC/ST category)

2

gj;jhk; tFg;g[ kjpg;bgz; gl;oaypd; rhd;wspf;fg;gl;l efy;

Attested copy of SSLC Mark Statement

3

khw;Wr; rhd;wpjHpd; rhd;wspf;fg;gl;l efy;

Attested copy of Transfer Certificate

4

rhjpr; rhd;wpjHpd; rhd;wspf;fg;gl;l efy;

Attested copy of Community Certificate

5

Kd;dhs; giltPuh; / Kd;dhs; giltPuupd; kfd;(s;) rhd;wpjHpd;

rhd;wspf;fg;gl;l efy;

Attested copy of ExServiceman / Son or daughter of ExServiceman Certificate

6

khw;Wj; jpwDilnahUf;fhd rhd;wpjHpd; rhd;wspf;fg;gl;l efy;

Attested copy of Certificate for otherwise-abled

7

midj;J kjpg;bgz; gl;oay;fspd; rhd;wspf;fg;gl;l efy;fs;

Attested copies of all Mark Statements

8

midj;J kjpg;bgz; gl;oay;fspd; rhd;wspf;fg;gl;l efy;fs; (tpUg;gj;

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; jpUr;rpuhg;gs;sp 620 024

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

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

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 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 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 filledin 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

tpz;zg;gg; got vz;.

Application Form No.

tpz;zg;gjhuh;

ifbahg;gkpl;l

gh];nghh;l; mst[

epHw;glj;ij ,q;nf

xl;lt[k;

Affix passport size photograph duly signed

by the applicant

* ,g;gotj;ij tpz;zg;gg; gotj;Jld; mDg;g ntz;lhk; Do not send this along with the application form