Sakthan Thampuran College of Mathematics & Am Bennet Road, 20. Phone : 2330199,2322299 P.P. Size centre: Phone: 2364488 Colour Photo

APPLICATION FORM

1 1. Name of Student (In block letters as entered in SSLC Certificate)

2. Date of Birth

3. Name of ParentIGuardian with :...... relationship

4. Occupation of ParentIGuardian : ...... 5. Name and address of School1 ...... College last attended

6. Address for correspondence

Telephone Number (with code) :

7. e-mail address

8. Official Address of

ParentIGuardian:

Telephone Number (with code) :

9. Course for which admission is C] Plus Two B.A C] B.Sc C] B.Com sought : (Tick Appropriate box) M.Sc M.Com M.A Others 10. Optional subject of the course : ...... 11. Second language required : C] C] Hindi 12. Year of passing qualifying examination with register NO...... 13 GradeIMarks obtained in qualifying examination

S1.b. Name of Subject Grademarks SI.No. Name of Subject Grademarks 1. 6. 2. ---7. 3. 8. 4. 9. 5. 10.

14. Aggregate Marks obtained in qualifying examination...... Max.Marks......

Rules & Reaulations

1. Fee once paid will not be refunded under any circumstance. 2. Students are not allowed to carry or use mobile phones1 other electronic devices in the premises of the institution. 3. Students in the Parallel wing are to wear their prescribed uniform on all working days and on special days when required by the college. 4. The college will not bear responsibility for the eligibility of a student for any examination or her acceptance as a candidate by the UniversityIBoard due to non compliance of rules or non submission of documents, fees etc. in time. 5. The college authorities reserve the right to suspend the privileges of studentship of any student who violates the rules and regulations of the institution. 6. Any misconduct on the part of the student in the classroom or anywhere else is sufficient reason for dismissal. There will be no refund of any amount paid in such cases, Declaration I have carefully read and understood all the above rules and regulations and promise toabide by it. Name of Student : ...... Name of Parent: ......

Signature : ...... Signature: ......

Place: ...... Date: ...... Place: ...... Date: ...... For Office use only

Admitted to : Plus Two1 B.AIB.Sc.lB.ComlM.Sc/M.Com/M.A...... with optional

Admission No. 71Receipt No. Date of Admn.

Amount Paid

Date : ......