Engineering & Technology

Application Number

6609238

1. Photo

ADMISSION 2014

3. NAME OF THE APPLICANT

2. SIGNATURE OF THE APPLCANT

SHRIMATHI A
4. GENDER 5 . COMMUNITY 6. DATE OF BIRTH

Female

OBC/BC/MBC

1996/06/11

7. STATE

8. MOBILE NUMBER

Tamil Nadu

9787022119

YOUR COMPLETE POSTAL ADDRESS FOR COMMUNICATION 9. S/o, D/o, C/o K.AYYANAR 10. Address 11 ANGUSAMY NAGAR

SRM UNIVERSITY

VANDIYUR

11. CITY MADURAI 12.DISTRICT 13.STATE 14.PINCODE

Madurai
15. STD CODE

Tamil Nadu
16.TELEPHONE NUMBER

625020

17.EMAIL ADDRESS: ayyanar2005@gmail.com

Application Printed Date: Saturday,25 Jan 2014 12:37:18 Ref ID:

Page 1 of 2

18. PERCENTAGE OF MARKS (%) OBTAINED IN

a) X STANDARD: 81.20

b) XI STANDARD:

19. DETAILS OF THE QUALIFYING EXAMINATION (XII STANDARD) PASSED

SCHOOL EXAM

 APPEARING
SCHOOL BOARD MONTH/YEAR OF PASSING % OF MARKS

MAHATMA Tamil Nadu Board of Higher May/2014 MONTESSORI Secondary Education MATRICULATION 20. DETAILS OF THE QUALIFYING HIGHER EXAMINATION FOR UG/ PG /PG DIPLOMA PROGRAMS SECONDARY SCHOOL PASSED APPEARING XII
QUALIFYING EXAM COLLEGE UNIVERSITY MONTH/YEAR OF PASSING AGGREGATE % OF MARKS

ADMISSION 2014

21. MODE OF ENTRANCE EXAM: Paper Pencil 23. DEGREE APPLIED

22. Test City Madurai 24. COURSE/SPECIALIZATION 1). Biomedical Engineering 2). Information Technology 3). Software Engineering

B.Tech.

SRM UNIVERSITY

25. Online Payment: DATE 25-Jan-14 12:35:40 PM, TXN REF NO 6609238/SRMEE14-15/25-01-2014 12:35:39

26.DECLARATION
"I hereby declare that I have carefully read the instructions and understood the particulars supplied to me and that the entr ies made in this application form are true and correct to the best of my knowledge and belief. I understand that the decision of th e University is final with regard to selection for admission. If selected for admission, I promise to abide by the rules and regulations of the University as existing and as would be amended from time to time. The University shall have the right to expel me from the University at any time after admission, provided it is satisfied that I was admitted on false particulars furnishe d by me or my antecedents proving that my continuance in the University is not desirable. Fees paid once will not be claimed back u nder any circumstances. I agree that all disputes are subject to the jurisdiction of the courts at Chennai only".

SIGNATURE OF APPLICANT
I have fully read the information furnished by my son / daughter / ward and affirm that it is true and correct. If any of the information provided to the University is false, my ward and I shall abide by the actions and decisions taken by the University.

VALID FOR THE ACADEMIC YEAR 2014-15

Application Printed Date: Saturday,25 Jan 2014 12:37:18 Ref ID: Page 2 of 2