4/23/2019 PRINT
[Link]: Date:
St. Joseph's College (Autonomous), Tiruchirapalli - 02
Application FOR U.G. COURSES (2019 - 2020)
SHIFT - I (8.30 a.m. - 1.30 p.m.)
[Link]. 19S1UG-14523
Name of the
R SNEHA
1 Applicant
Course Applied for B Voc Software Devep.
2 Gender: Female 3. Date of Birth: 14/12/2001 4. Blood Group: AB+
5 Community BC/OBC Caste : yadhar
6 Religion Hindu a) Dalit Catholic : No
Nationality INDIAN Aadhaar No. : 947002984035 Mother Tongue : TAMIL
7
State TAMIL NADU Village/Town: TRICHY
Is Physically
8 No 9. Special Category Orphan : No Rural : Yes
Challenged?
Parent's Details Name Education Occupation Annual Income
10 Father R RAJA 12 DRIVER
Rs.80000/-
Mother R REVATHI 10 HOME MAKER
First generation graduate in your
11 Yes Ex-serviceman : No
family
12 Extra Co-Curricular Activities : Others
Name of the School, Place last studied
HOLY CROSS [Link] SCHOOL, TRICHY
:
Medium of Instruction in +2 : English
13 Board of Examination Passed : HSC
Year of Passing : APR-2019 Exam. Registration No. : 4485691
Tamil English Computer science Physics Chemistry Mathematics Total Marks
76 81 87 46 50 44 384 / 600
Address Communication Address : Parent's / Student's Mobile No. :
14. 42BRAJAPILLAI STORE , KEELAPUDUR , TRICHY- 9486146697 | 9486146697
1.-620001 E-mail ID : indupoovizhi97@[Link]
DECLARATION: I, R SNEHA, promise to abide by the rules and regulations of the College. All the particulars
stated in this application are true to the best of my knowledge and belief.
Signature of the Applicant
UNDERTAKING BY PARENT OR GUARDIAN: I........................................................promise to pay my ward's fee
to the College and I take responsibility for his / her progress in studies, regular attendance and discipline if my ward
is admitted.
Date : 23-04-2019
Signature of the Parent / Guardian
Certificate Verification HOD Verification Principal
[Link]/SJC19/[Link] 1/1