APPLICATION FORM

1. NAME OF THE CANDIDATE (as per record)*
2. GENDER*	Male Female
3. DATE OF BIRTH*
4. EMAIL ID*
5. MOBILE NUMBER*
6. RELIGION*
7. NATIONALITY*
8. COMMUNITY*	OC BC MBC SCA SC/ST
9. CASTE*
10. DIFFERENTLY ABLED PERSON*	Yes No
11. COURSE APPLIED FOR*
12. FIRST GENERATION LEARNER*	Yes No
13. NAME OF THE SCHOOL (Last Studied)*
14. EXAMINATION QUALIFIED *	Yes No
15. MONTH & YEAR OF PASSING (If Yes)*
16. MEDIUM OF INSTRUCTION (Last Studied)*	Tamil English
17. BOARD OF EXAMINATION*	State Central Other
18. MARK STATEMENT (Subjects)*
SUBJECT	MARK






19. TOTAL MARKS*
20. PERCENTAGE*

THANK YOU

. YOUR APPLICATION SUBMITTED SUCCESSFULLY...

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