Annexure - 1

Dr. Mahalingam College of Engineering & Technology :: Pollachi 03

Application Form for Annual Day Arutchelvar Award & Best Outgoing Students Award

(Final year students only)

Department:Applied Sciences Branch:CT 1. Personal Details and Academic Details: S.No 1. 2. Name S.BIRUNDHAA Roll No 09ACT209 Final year Section: III B.Sc CT Date: 17/ 02/ 2012. Remarks if any

I 87

Average % of marks in year II III IV V Overall 87 91 93 88 90

Passed in First attempt (Yes / No.): YES If no, mention the number of attempt and no. of subjects

3. Attendance: Attendance % 1 100 2 100 3 100 4 92 Semester 5 6 98 84* 7 8 (till now)

*(till date) 4. Participation, Achievements and awards in Cocurricular Activities: (Dept. Association, SGS, SWG, Club Science, Robotics, Renewable Energy, quiz, ISTE, IEEE, ISOI, SAE etc.) S. No 1 Name of the Cocurricular Activities QUIZ Details of Achievements / awards PARTICIPATION Period of activities/award NOV 2009 Remarks if any Nil

5. Participation, Achievements and awards in Extracurricular Activities: (Muthamil Mandram, Fine arts club, NLFO, YRC, RRC, NSS, NCC, Sports etc.) S. No 1 2 3 4 Name of the Extra curricular Activities NSS ESSAY WRITING COMPETITION SPORTS LIMCA BOOK OF RECORDS Details of Achievements / awards ATTENDED NSS CAMP HELD AT KOLLAPATTI PARTICIPATION 1500 mts PARTICIPATION Period of activities / award 1 WEEK 7 FEB 2011 MAR 2010 MAR 2011 THIRD PLACE Remarks if any

6. Any other achievements: (Paper presentation, Projects, Extension Activities, Placement etc.) S. No Details of the activities Nil Place in which awarded Nil Period for which awarded Nil Remarks if any Nil

7. Did he / she avail any scholarship / award from MCET or others? (Yes / No) : YES If yes, please mention its detail Name of the Sponsor Amount (in Rs.) / Award Date Remarks if any DR.MCET PROFICIENCY AWARD Feb 2011 SECOND RANK HOLDER

This is to certify that the above information are true to best of my knowledge. Comments of PC with Signature, Name and Date Comments of HoD with Signature and Name