Professional Documents
Culture Documents
Application No:
Paste your recent
passport size color
photograph not older
Academic Year: than 3 months.
Do not staple or pin.
Fill the form in English using CAPITAL letters.
Use only Black or Blue ink. Do not fold, staple or clip the form. Please leave space between words.
Read the Specific Instructions to fill Application Form before filling the form.
7. (b) As per the Govt. list belongs to: ST SC MBC OBC FC Others Specify
(Only for statistical purpose)
9. Permanent Address:
(b) Relationship:
(c) Address:
1) Name
2) Qualification
3) Occupation
4) Name of Organization
5) Office Address
7) Mobile No.
8) E-Mail ID
Year Studied
% of
S. No. Class Name and Address of the Institution Marks
From To
Month / Year Month / Year
1) X Std
2) XII Std
3) Diploma
Mathematics
English
Language
(Specify)
Subject 1
(Specify)
Subject 2
(Specify)
Subject 3
(Specify)
Overall Total
(for all the subjects)
Others Specify
Register No.
Register No.
19. Extra Curricular Activities (Original Certificate must be produced at the time of admission)
b) NCC: c) NSS:
23. Has any relative of yours studied / been studying in this college, if so, give details
Discipline: Relationship:
25. Checklist (To be submitted with filled in Application Form duly attested by Gazetted officer / Head of Institution of the
School, where last studied.)
Copy of the NATA Score Card Copy of the Xth Mark Sheet Copy of the XIIth Mark Sheet
Copy of the School Transfer Certificate Copy of the Conduct Certificate Copy of Linguistic Minority Certificate
Copy of the Community Certificate Copy of the Migration Certificate 5 Passport Size Photographs
(including the one affixed on the form)
The students should produce all the original certificates at the time of admission
Staff-In-Charge Signature
Director, MIDAS
Specific Instructions to Fill Application Form
General
Use only Black or Blue ink. Fill the form in English using CAPITAL letters, except for Signature. Do not fold, staple or clip the form.
Please leave space between words.
Guidelines to Fill the Application Form
1. Write your name in BLOCK letters, with initials at the end. Exactly in the same way as it has been given in all your X & XII Std
mark sheet. If your name is R. TAMIL SELVAN write it as TAMIL SELVAN R
2. Write your Date of Birth in (dd/mm/yyyy) format. If your Date of Birth is 4th September, 1994, write it as 04/09/1994
3. Tick M for Male or F for Female
4. Specify your Nationality. For example, INDIAN
5. Write your Mother Tongue. For example, TAMIL
6. Write your Religion. For example, HINDUISM
7. (a) Specify your caste. For Example, VANNIYAR
(b) Tick the appropriate Govt. list category to which your caste belongs
8. Provide full communication address details with Door no., Street name, City in the space provided
9. Provide full permanent address details with Door no., Street name, City in the space provided
10. Provide Guardians Details with Door no., Street name, City in the space provided
11. Provide Parents Details in the space provided
12. Provide School Education Details in the space provided. Write the address of the school
13. Tick your qualifying examination
14. Specify the board of your qualifying examination. For example, Andhra Pradesh Board of Intermediate Education or
Tamil Nadu State Board of School Education
15. (a) Fill up the HSC (Academic)/Equivalent Examination Marks of the subjects in the appropriate column. If the marks obtained
in Mathematics is 191, English is 160, Tamil is 190, Physics is 193, Chemistry is 187 and Biology is 179 and the overall total marks
is 1100 and the maximum marks in each subject is 200 and the overall total maximum mark is 1200.Enter Mathematics marks in
Mathematics column, English mark in English column, Tamil mark in Language column, Physics, Chemistry and Biology (subjects
applicable to the candidate) marks in remaining columns and the overall total in overall column. (b) Specify the name of the
Diploma Course. (c) Fill up the First, Second and Third year Diploma total maximum marks and total marks obtained in the
appropriate column. If total maximum marks for First, Second and Third year are 1200 each and the total marks obtained in First
year is 1030, Second year is 953 and Third year is 987, then overall marks obtained is 2970 out of 3600. (d) Tick the medium of
instruction of the qualifying examination. (e) Provide the details of no. of attempts of passing the qualifying examination in the
space provided. (f) Provide no. of improvements in the qualifying examination in the space provided.
16. Write your NATA Score and NATA Registration Number as specified
17. Tick the category under which the admission is sought
18. Tick the Govt. quota category under which you are admitted to the institution
19. Provide details of your extracurricular activities, if applicable
20. Tick the appropriate check box
21. Tick the appropriate check box
22. Tick the appropriate check box
23. Provide necessary details (if applicable) about any relative who is already a part of MIDAS Student Community
24. Both Parent/Guardian and Candidate need to sign the declaration
25. All the items given in the checklist are mandatory submissions. Candidates are required to tick against the space provided