LOYOLA COLLEGE (AUTONOMOUS), CHENNAI-34
APPLICATION FOR U.G. COURSES (2020-2021)
SHIFT I (8.15 a.m. - 1.15 p.m.)
Appl.No. 20S1UG-014153
Name of the Applicant PROMOTHJI G
1
Language Studied in 10th Tamil Language Studied in +2 Tamil
2 Course Applied for B.Com.-Commerce
3 Date of Birth 21-05-2002 4. Gender : MALE 5. Blood Group : O+ve
6 Community (As in T.C.) BC Caste : VADUGAR
7 Religion HINDU
8 a) Dalit Catholic (SC converted Catholic) : No
9 Nationality Indian Aadhaar No. : 328047019649 Mother Tongue : Tamil
State District Town Village
A ) Indian
Tamil Nadu Tiruvannamalai POLUR POLUR
Country Visa/PCO/OCI No. Passport No. Passport Validity
B ) NRI / Foreigner
India - - -
10 Is Physically Challenged? No
11 Special Category Refugee : No Orphan : No Semi-orphan : No
Parent's Details Name Education Occupation Annual Income
12 Father GANDHI SSLC Daily Wages / 36000.00
Mother RANJINI 12TH Not working 0.00
First generation graduate in your family No
13 Child of Defence Personnel (In-Service) No Ex-serviceman : No Nativity URBAN
Ex-serviceman / Defence Person Details Not Applicable
Seeking admission under Sports No
Name of the school, place last studied THE NAMAKKAL TEACHERS VIDHYASHRAM , VELLORE
Medium of Instruction in +2 English T.C.No. Year of Passing
Board of Examination Passed Other Board/State Stream General March-2020
14 Have you cleared all the subjects in 11th Standard? Yes Exam. Registration No. : 2645406
Tamil/Other English / Economics Commerce Accountancy Business Total Marks Without
Total Marks
Language Second Maths Language
Language Obtained
37 63 42 56 43 35 276 / 600 176 / 400
Permanent Address : Communication Address :
Communication
46 PANDIYAN STREET 46 PANDIYAN STREET
15. Address for
POLUR POLUR
POLUR PIN : 606803 POLUR
Student's Mobile No. : 9042643367 PIN : 606803
Parent's Mobile No. : 9944728358 Guardian's Mobile No. :
E-mail ID : [email protected] E-mail ID : [email protected]
16 Admission into Loyola College does not guarantee admission into Loyola men's and women's Hostels.
DECLARATION
I, PROMOTHJI G, do hereby sincerely affirm that the statements made by me in the application and the information
furnished are true. Should it, however, be found untrue at a later stage, I am liable for criminal prosecution and
disqualification. I am also fully aware of the ELIGIBILITY CRITERIA, general instructions and I am bound by the same. I
promise to abide by the rules and regulations of the College. Having understood the implications, on my own free will, I am
making this declaration.
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
discipline, progress in studies and regular attendance if my ward is admitted.
Date : 31/07/2020 Signature of the Parent / Guardian
