ANNEXURE – I
ANNA UNIVERSITY CHENNAI, CHENNAI – 600 025
CENTRE FOR UNIVERSITY – INDUSTRY COLLABORATION
TAMIL NADU STATE LEVEL PLACEMENT PROGRAM (TNSLPP)
2009 – 2010
REGISTRATION FORM
Name: _______________________________ Sex: _________
Reg. No: _______________________________
Branch: _______________________________
College: _______________________________________________
Date of Birth: _______________________________ Age: __________
Residential Address: __________________________________________
__________________________________________
__________________________________________
Phone No: _______________________ Mobile: __________________________
E-Mail Id: ________________________
Academic Profile:
Course SSLC HSC Diploma (For B.E
Lateral Entry) (Upto 7 th Sem)
Percentage
Month / Year of Passing
Semester 1 2 3 4 5 6 7 Average
% of Marks
Draft No: _______________ Dated : _________________ Bank : __________________________
I hereby declare that the information’s provided above, are true to best of my knowledge.
Student’s Signature