GOVERNMENT OF TAMIL NADU

DIRECTORATE OF COLLEGIATE EDUCATION

TAMIL NADU GOVT ARTS AND SCIENCE COLLEGES ADMISSIONS - 2024
Application for Admission to Arts and Science Degree Course
Application Number: 777846

Personal Information
Name: SUSMITHA .P Name of the Parent/Guardian: PANDIYARAJAN .K
Communication Address: Permanent Address: 527, ERUKALAI VELLUR AMBALATHADI, SIVAGANGA-11
527, ERUKALAI VELLUR AMBALATHADI, SIVAGANGA-11
Alternate mobile number: 9080886250 State: Tamil nadu
District: Sivaganga Taluk: Thirupuvanam
Communication address pincode: 630611 Native District: Sivaganga
Civic status of Native Place: Village Panchayat Date of Birth (DD-MM-YYYY): 15-03-2007
Gender: Female Mother Tongue: Tamil
Nationality: Indian Religion: Hindu
Name of the Community: BC Name of the Caste: Agamudayar including Thozhu or Thuluva Vellala
Aadhar Number (optional): --

Special Reservation Information

Whether you are a candidate under quota for Eminent Sports person?: No Level of Participation: --
Ex-Servicemen (Only Army/Navy/ Air force services are Eligible): No Differently Abled Person: No
Differently Abled Type: -- NCC (A) Certificate Holder: No
Tamil Origin from Andaman & Nicobar Island: No Select Children/Widows of eligible Personnel of Security Forces Category:
None of the Above
AFC Center for certificate verification:
Sri Meenakshi Government Arts College for Women(Autonomous) - 625002

Scholarship Information
Parent Occupation: Agriculture Annual Income: 72000
Are you a First Graduate?: Yes Post Matric Scholarship (SC/SCA/ST/Converted Christians): No

School of Study Information

Category of School: State Govt Civic status of school location (+2): Corporation
Have you studied VI to XII in Government school?: Yes

Class Year of Passing Name of the school District State Block Category of
Govt.School

VI Std. 2018 Corporation Masathiyar Girls Hr Sec Madurai Tamil nadu Madurai South GOVERNMENT
School, Manjanakara Street

VII Std. 2019 Corporation Masathiyar Girls Hr Sec Madurai Tamil nadu Madurai South GOVERNMENT
School, Manjanakara Street

VIII Std. 2020 Corporation Masathiyar Girls Hr Sec Madurai Tamil nadu Madurai South GOVERNMENT
School, Manjanakara Street

IX Std. 2021 Corporation Masathiyar Girls Hr Sec Madurai Tamil nadu Madurai South GOVERNMENT
School, Manjanakara Street

X Std. 2022 Corporation Masathiyar Girls Hr Sec Madurai Tamil nadu Madurai South GOVERNMENT
School, Manjanakara Street

XI Std. 2023 Corporation Masathiyar Girls Hr Sec Madurai Tamil nadu Madurai South GOVERNMENT
School, Manjanakara Street

XII Std. 2024 Corporation Masathiyar Girls Hr Sec Madurai Tamil nadu Madurai South GOVERNMENT
School, Manjanakara Street

Academic Information
Qualifying Examination: TN-HSC Name of the Board of Examination: Tamil nadu Board of Higher Secondary Education
Permanent register number: -- HSC Roll number: 6155802
Qualified Year: 2024 HSC Group: HSC Academic
Group Code: PHYSICS/CHEMISTRY/COMPUTER SCIENCE/MATHEMATICS Medium of Instruction: Tamil
Educational Management Information System(EMIS) Number: 1000832371 Community certificate number: TN-5202012112861
 GOVERNMENT OF TAMIL NADU
DIRECTORATE OF COLLEGIATE EDUCATION
TAMIL NADU GOVT ARTS AND SCIENCE COLLEGES ADMISSIONS - 2024
Application for Admission to Arts and Science Degree Course
Application Number: 777846

Subjects Permanent Register Number/Roll Month Year Maximum Mark Obtained Mark No. of Attempts
Number

TAMIL 6155802 March 2024 100 50 1

ENGLISH 6155802 March 2024 100 37 1

PHYSICS 6155802 March 2024 100 47 1

CHEMISTRY 6155802 March 2024 100 50 1

COMPUTER SCIENCE 6155802 March 2024 100 57 1

MATHEMATICS 6155802 March 2024 100 35 1

 GOVERNMENT OF TAMIL NADU
DIRECTORATE OF COLLEGIATE EDUCATION
TAMIL NADU GOVT ARTS AND SCIENCE COLLEGES ADMISSIONS - 2024
Application for Admission to Arts and Science Degree Course
Application Number: 777846

Affix recent Passport

size Photo

DECLARATION BY THE APPLICANT

I, SUSMITHA .P (Son / Daughter) of PANDIYARAJAN .K hereby solemnly declare that the information furnished and the statements given
in the application and the enclosures are true, correct and complete. I further declare that should it be found otherwise, I will be liable to forfeit
my seat and / or removal from the rolls of the Institution at whatever stage of study I may be, besides making me liable for criminal prosecution.
I am fully aware that as per the directions of the Hon'ble Supreme Court of India and Tamil Nadu Prohibition of Ragging Act 1997, Ragging
is an offence, as is banned in the Institutions and anyone indulging in ragging is liable to be punished such as expulsion from the Institutions
and / or rigorous imprisonment up to 3 years, and / or fine up to Rs.25,000/-

Place:

Date: ( Signature of the Applicant )

DECLARATION BY THE PARENT/ GUARDIAN

I, PANDIYARAJAN .K (Parent / Guardian) of SUSMITHA .P hereby solemnly declare that I am fully aware of the declaration made by the
applicant, and I declare and bind myself on the same terms contained in the above declaration. The statements and the information given are
true, correct and complete. If it is found otherwise, the applicant is liable to forfeit the seat and / or removal from the rolls of the Institution at
whatever may be the stage of study, besides making me liable for criminal prosecution I am fully aware that as per the directions of the Hon'ble
Supreme Court of India and Tamil Nadu Prohibition of Ragging Act 1997,Ragging is an offence, as is banned in the Institutions and anyone
indulging in ragging is liable to be punished such as expulsion from the Institution and / or rigorous imprisonment up to 3 years, and / or fine
up to RS. 25,000/-

Place:

Date: ( Signature of Parent / Guardian )

Note: Guardian can execute the above declaration, only if both the parents are not alive.
 GOVERNMENT OF TAMIL NADU
DIRECTORATE OF COLLEGIATE EDUCATION
TAMIL NADU GOVT ARTS AND SCIENCE COLLEGES ADMISSIONS - 2024
Application for Admission to Arts and Science Degree Course
Application Number: 777846

The following original certificates have to be produced at the time of certificate verification.

1. Transfer certificate
2. 10th Mark Sheet
3. 12th Mark Sheet
4. Permanent Community Certificate Card for BC (Permanent card / Electronic form / Digitally Signed E-Certificate)
5. Income Certificate of the Parent
6. Special Reservation Form for Sports and relevant certificates
7. Special Reservation Form for Ex-Serviceman and relevant certificates
8. Special Reservation Form for Blindness & Low Vision and relevant certificates
9. Special Reservation Form for NCC-'A' Certificate holders and relevant Certificates

Printout of the application, Signed declaration and photocopies of all the above mentioned certificates need to be submitted
at the time of Admission
 GOVERNMENT OF TAMIL NADU
DIRECTORATE OF COLLEGIATE EDUCATION
TAMIL NADU GOVT ARTS AND SCIENCE COLLEGES ADMISSIONS - 2024
Application for Admission to Arts and Science Degree Course
Application Number: 777846

Choices Selected
District Course Id Course Name College Name College Code Preference Or-
der

Madurai SCSE1 B.Sc. Computer Science (E/M) ( Sri Meenakshi Government Arts College for Women(Autonomous) - 625002 1042001 1
1ST SHIFT )

Madurai SCSE2 B.Sc. Computer Science Sri Meenakshi Government Arts College for Women(Autonomous) - 625002 1042001 2
(E/M) ( 2ND SHIFT )

Madurai LTAT1 B.A. Tamil ( 1ST SHIFT ) Sri Meenakshi Government Arts College for Women(Autonomous) - 625002 1042001 3

Madurai LTAT2 B.A. Tamil ( 2ND SHIFT ) Sri Meenakshi Government Arts College for Women(Autonomous) - 625002 1042001 4

Madurai SCHT1 B.Sc. Chemistry (T/M) ( 1ST Sri Meenakshi Government Arts College for Women(Autonomous) - 625002 1042001 5
SHIFT )