APPLICATION FORM

ADMISSIONS FOR THE ACADEMIC YEAR 2023 - 2024

Personal Details (Fill the Form Carefully not Editable) All fields are mandatory

Name of the Applicant (in Block Letters)
(விண்ணப்பதாரரின் பெயர்) :

Father Name
(தந்தை பெயர்) :

Mother Name
(தாய் பெயர்) :

Username :

Password :

Date of Birth as per HSc Certificate
(பிறந்த தேதி) :

E-Mail
(மின்னஞ்சல் முகவரி) :

AAdhar Number
(ஆதார் எண்) :

Nationality
(தேசம்):

Religion
(மதம்):

Mother Tongue (தாய்மொழி):

Community (சமூக நிலை):

Caste (சாதி) :

Father Occupation (தந்தை தொழில்):

Annual Income (ஆண்டு வருமானம்):

Photo Upload Max. File size(Maximum 300kb)
(புகைப்படம் பதிவேற்றம்):

Father Qualification (தந்தை படிப்பு):

Contact Number (கைபேசி எண்):

Alternative Number (கைபேசி எண்):

Contact Number (தொலைபேசி எண்):

Alternative Number (கைபேசி எண்):

Communication Address

Door Number:

Street Name:

Village / Town:

Postal / City:

Taluk:

District:

Pincode:

Permanent Address If Same as (click)

Door Number:

Street Name :

Village / Town:

Postal / City:

Taluk:

District:

Pincode:

Apply UG Details

Choose Course Name :

Name of the School (பள்ளியின் பெயர்):

School Address (பள்ளியின் முகவரி):

Passed out Year :

Number of Attempts :

Name of the Board :

Eleventh :

S.No	Subject	Register Number		Marks Obtained
S.No	Subject	11th	12th	11th	12th
1
2
3
4
5
6

Proficiency in the following areas

Sports

Extra Curricular Activities

Applicant been in receipt of any Scholarship (if 'Yes' means enter the details) : Yes No

College Bus (Pickup Point) (if 'Yes' means enter the details) : Yes No

Own Bus (if 'Yes' means enter the details): : Yes No

Hostel (if 'Yes' means enter the details): Yes No

Choose Reference :

Knowing about college through :

Enclosure Details

SSLC(10th Marksheet) :

HSC(11th Marksheet) :

Aadhar Card :

Community Certificate :

Income Certificate :

Bank Details

Name	Jawaharlal Nehru College for Women
Account Number	612866566
IFSC Code	IDIB000U035
Bank Name	Indian Bank
Branch Name	Ulundurpet
Pay Rs.	3500/-

Choose Payment

Attach Copy *Mandatory :

Transaction Number :