Application No: 19UG43495

JAMAL MOHAMED COLLEGE (Autonomous)

7 , Race Course Road , TIRUCHIRAPPALLI - 620020. INDIA
College with Potential for Excellence
Re-accredited (3rd Cycle) with 'A' Grade by NAAC
(Affiliated to Bharathidasan University)
APPLICATION FOR ADMISSION - (2019)
U.G COURSES
(Un-Aided Courses-Women)

COURSE APPLIED FOR : B.Sc. - FASHION TECHNOLOGY AND COSTUME DESIGNING

For office use:

Admitted in : _________________________________________ on _____________________

Language Under Part I : Tamil Arabic French Hindi Urdu

Applicant's Name (In English) JOYCE ESTHER RAJATHY P

Address for Communication Permanent Address

_______________________________________________________________________________________________________________
10,ANNA NAGAR,SIMCO METER OPPOSITE,/KK NAGAR 10,ANNA NAGAR,SIMCO METER OPPOSITE,
_______________________________________________________________________________________________________________

TRICHY TRICHY
_______________________________________________________________________________________________________________

Tamil Nadu Tamil Nadu

_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
Pincode: 620021
______________________________________________________________________________________________________________
Pincode: 620021
E-mail: princyjproy007@gmail.com Mobile No: 9384242533

Nationality : INDIAN

Date of Birth : 14/10/2001 Aadhar Card No. :

Place of Birth : TRICHY

Religion & Community : CHRISTIAN & BC Caste : AADHI DRAVIDAR

Blood Group : A+VE Mother Tongue :

Distinction in Sports : No.

Extra Curricular Activites / Co-Curricular Activites : No

______________________________________________________________________________________________________________
Whether differently-abled : No

Whether son of Ex-serviceman : No

Hostel accommodation : No

PARTICULARS OF THE PARENTS/GUARDIAN

Father's Name (in English) PRINCE RAJ J

Occupation BUSINEES
_________________________________________________ Annual Income 12991
__________________________

Contact No. 9976083822

__________________________ Email ID ______________________________
Mother's Name ELIZABETH P
__________________________________________________________________________________________
Occupation HOSEWIFE
___________________________________________ Annual Income ________________________________
Contact No. 6380271441
______________________________ E-mail ID ________________________________________________
Guardian's Name (if living with guardian) ____________________________________________________________________
Contact No. ________________________________ E-mail ID ______________________________________________

PARTICULARS OF PREVIOUS ACADEMIC RECORD

Qualifying exam passed : HSC

Institution last attended : PEIYAR MANIAMMAI GIRLS HIGHER SECONDARY SCHOOL

(With Address & Contact Nos) : TRICHY

EXTRACT OF THE MARK STATEMENT(S) OF THE QUALIFYING EXAMINATION PASSED

Subjects Register No Mark Maximum Marks Month Year No.of Attempts

Tamil 4488802 55 100 Apr 2019 1
English 4488802 67 100 Apr 2019 1
Economics 4488802 60 100 Apr 2019 1
Commerce 4488802 67 100 Apr 2019 1
Accountancy 4488802 66 100 Apr 2019 1
Business maths 4488802 46 100 Apr 2019 1
Total Marks Secured 361 600

NOTE
1. Fill up the application form as per the data mentioned in your +2 Mark sheet & T.C.
2. Omission or withholding details required or giving incorrect information will result in summary rejection of application or
cancellation of admission.

Our College does not collect capitation fee for admission to any course

DECLARATION

* I declare that particulars given here are correct and I will, if admitted, abide by the rules and regulations of the College. I assure
that I will not take part in political or agitational activities inside or outside the College and I further promise that I will
behave in a manner that will bring credit to the College and to our Country

* I am aware of the law regarding the prohibition of ragging as well as the punishments and if found guilty of the offence of
ragging and / or abetting ragging, is liable to be punished appropriately. I agree to abide by the punishment in case I am found
guilty of ragging and / or abetting ragging.

Date :25/04/2019

Station : Signature of the Parent/Guardian Signature of the Student

Name :

--------------------------------------------------------------------FOR OFFICE USE ONLY--------------------------------------------------------------

Certificates verified

HSC Marks Community Transfer

Conduct Spl. Category

Signature of Staff Who Processed the application :___________________________________

Signature of Head of the Department : ____________________________________________ ADMITTED
Date of Payment :
Bill No :
PRINCIPAL
Application No: 19UG43496

JAMAL MOHAMED COLLEGE (Autonomous)

7 , Race Course Road , TIRUCHIRAPPALLI - 620020. INDIA
College with Potential for Excellence
Re-accredited (3rd Cycle) with 'A' Grade by NAAC
(Affiliated to Bharathidasan University)
APPLICATION FOR ADMISSION - (2019)
U.G COURSES
(Un-Aided Courses-Women)

COURSE APPLIED FOR : B.VOC - APPAREL AND FASHION DESIGN

For office use:

Admitted in : _________________________________________ on _____________________

Language Under Part I : Tamil Arabic French Hindi Urdu

Applicant's Name (In English) JOYCE ESTHER RAJATHY P

Address for Communication Permanent Address

_______________________________________________________________________________________________________________
10,ANNA NAGAR,SIMCO METER OPPOSITE,/KK NAGAR 10,ANNA NAGAR,SIMCO METER OPPOSITE,
_______________________________________________________________________________________________________________

TRICHY TRICHY
_______________________________________________________________________________________________________________

Tamil Nadu Tamil Nadu

_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
Pincode: 620021
______________________________________________________________________________________________________________
Pincode: 620021
E-mail: princyjproy007@gmail.com Mobile No: 9384242533

Nationality : INDIAN

Date of Birth : 14/10/2001 Aadhar Card No. :

Place of Birth : TRICHY

Religion & Community : CHRISTIAN & BC Caste : AADHI DRAVIDAR

Blood Group : A+VE Mother Tongue :

Distinction in Sports : No.

Extra Curricular Activites / Co-Curricular Activites : No

______________________________________________________________________________________________________________
Whether differently-abled : No

Whether son of Ex-serviceman : No

Hostel accommodation : No

PARTICULARS OF THE PARENTS/GUARDIAN

Father's Name (in English) PRINCE RAJ J

Occupation BUSINEES
_________________________________________________ Annual Income 12991
__________________________

Contact No. 9976083822

__________________________ Email ID ______________________________
Mother's Name ELIZABETH P
__________________________________________________________________________________________
Occupation HOSEWIFE
___________________________________________ Annual Income ________________________________
Contact No. 6380271441
______________________________ E-mail ID ________________________________________________
Guardian's Name (if living with guardian) ____________________________________________________________________
Contact No. ________________________________ E-mail ID ______________________________________________

PARTICULARS OF PREVIOUS ACADEMIC RECORD

Qualifying exam passed : HSC

Institution last attended : PEIYAR MANIAMMAI GIRLS HIGHER SECONDARY SCHOOL

(With Address & Contact Nos) : TRICHY

EXTRACT OF THE MARK STATEMENT(S) OF THE QUALIFYING EXAMINATION PASSED

Subjects Register No Mark Maximum Marks Month Year No.of Attempts

Tamil 4488802 55 100 Apr 2019 1
English 4488802 67 100 Apr 2019 1
Economics 4488802 60 100 Apr 2019 1
Commerce 4488802 67 100 Apr 2019 1
Accountancy 4488802 66 100 Apr 2019 1
Business maths 4488802 46 100 Apr 2019 1
Total Marks Secured 361 600

NOTE
1. Fill up the application form as per the data mentioned in your +2 Mark sheet & T.C.
2. Omission or withholding details required or giving incorrect information will result in summary rejection of application or
cancellation of admission.

Our College does not collect capitation fee for admission to any course

DECLARATION

* I declare that particulars given here are correct and I will, if admitted, abide by the rules and regulations of the College. I assure
that I will not take part in political or agitational activities inside or outside the College and I further promise that I will
behave in a manner that will bring credit to the College and to our Country

* I am aware of the law regarding the prohibition of ragging as well as the punishments and if found guilty of the offence of
ragging and / or abetting ragging, is liable to be punished appropriately. I agree to abide by the punishment in case I am found
guilty of ragging and / or abetting ragging.

Date :25/04/2019

Station : Signature of the Parent/Guardian Signature of the Student

Name :

--------------------------------------------------------------------FOR OFFICE USE ONLY--------------------------------------------------------------

Certificates verified

HSC Marks Community Transfer

Conduct Spl. Category

Signature of Staff Who Processed the application :___________________________________

Signature of Head of the Department : ____________________________________________ ADMITTED
Date of Payment :
Bill No :
PRINCIPAL