GOVERNMENT OF TAMIL NADU

DIRECTORATE OF TECHNICAL EDUCATION

TAMIL NADU ENGINEERING ADMISSIONS 2019

Application No. : 144908

Personal Information
Name RAMTHILAK P Nativity Tamil Nadu
Parent Name PANDIYAN I Religion HINDU
11A WEST,BALIZAWAR
Permanent Address STREET,KARUR KARUR TAMIL Community MBC/DNC
NADU -639001
Mobile Number 9629804267 Caste Name - Code Maruthuvar-150
Email thilakram308@gmail.com Aadhar Number
Date of Birth 11-12-2001 Nationality INDIAN
Gender MALE
Special Reservation Information
Eminent Sports Person NO Differently Abled Person NO
Exservicemen NO
Scholarship Information
Annual Income Below Rs. 1,00,000
Availed First Graduate Tuition Fee
First Graduate Tuition Fee Concession YES NO
Concession
AICTE Tuition Fee Waiver (TFW)
NO Post Matric Scholarship
Scheme
School of Study Information
Studied VIII, IX, X, XI & XII Std. in Tamil Nadu School of Study YES
Class Year of Passing Name of the School District State
SRI GURUBRAMMA
VIII Std. 2015 VIDYALAYA MATRIC KARUR TAMIL NADU
SCHOOL,MANAVAADI
SRI GURUBRAMMA
IX Std. 2016 VIDYALAYA MATRIC KARUR TAMIL NADU
SCHOOL,MANAVAAD
SK VIDYAPEEDAM HR SEC
X Std. 2017 KARUR TAMIL NADU
SCHOOL,MANAVAADI
SK VIDYAPEEDAM HR SEC
XI Std. 2018 KARUR TAMIL NADU
SCHOOL,MANAVAADI
SK VIDYAPEEDAM HR SEC
XII Std. 2019 KARUR TAMIL NADU
SCHOOL,MANAVAADI

Academic Information
Qualifying Examination HSC
Name of the Board of Examination Tamilnadu-Tamilnadu Board of Higher Secondary Education
HSC/Equivalent Register Number & Year : 4441421 - 2019
HSC Group & Group Code : HSC Academic - 1503
Marks Obtained in HSC (Academic/Equivalent) Examination
Subject Register Number Month Year Maximum Mark Obtained Mark
Physics 4441421 Mar 2019 100 46
Chemistry 4441421 Mar 2019 100 67
Mathematics 4441421 Mar 2019 100 39
Optional 4441421 Mar 2019 100 62

Civic Information
Mother Tongue TAMIL Civic Native Municipality
Medium Of Instruction ENGLISH Civic School Village Panchayat
Parent Occupation Others Native District KARUR
 TAMIL NADU ENGINEERING ADMISSIONS 2019
Application for Admission to B.E/B.Tech Degree Course
Application No. : 144908

The Following Original Certificates have to be produced at TFC, at the time of Certificate Verification.
Venue, Date and Time will be intimated through SMS to the registered mobile and Email id.

1. Transfer Certificate

2. 10th Mark Sheet

3. 11th Mark Sheet

4. 12th Mark Sheet

5. HSC Hall Ticket

6. Permanent Community Certificate Card (Permanent card / electronic form / digitally signed e-Certificate)

7. Income Certificate of the Parent if applicable

8. Nativity Certificate if applicable

9. Special Reservation Form For Sports and relevant certificates if applicable

10. Special Reservation Form For Ex-serviceman and relevant certificates if applicable

11. Special Reservation Form For Differently Abled and relevant certificates if applicable

Printout of the application, Signed declaration and photocopies of all the above mentioned certificates need to be submitted at TFC, at
the time of Certificate Verification.
 TAMIL NADU ENGINEERING ADMISSIONS 2019
Application for Admission to B.E/B.Tech Degree Course
Application No. : 144908
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DECLARATION BY THE APPLICANT

I,RAMTHILAK (P Son / Daughter) of PANDIYAN I 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 Tamilnadu 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 upto 3
years,and / or fine upto Rs. 25,000/-

Place :
(Signature of Applicant)
Date :

DECLARATION BY THE PARENT / GUARDIAN

I,PANDIYAN I (Parent / Guardian) of RAMTHILAK Phereby 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 Institition 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 Tamilnadu 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 upto 3 years,and / or fine upto RS. 25,000/-

Place :
(Signature of Parent / Guardian)
Date :

Note: Guardian can execute the above declaration,only if both the parents are not alive.