Application No : 973

Online No. : 13722283979

Date : 03/08/2021
Quota : Open Merit, Management

APPLICATION FOR ADMISSION TO FIRST DEGREE PROGRAMME - 2021

1. Name : JOSLIEN JEROMIAS 

2. Gender : Female
3. Date of Birth : 26/08/2003
4. Nationality : Indian
5. Domicile State : Kerala
6. Religion : CHRISTIAN
7. Caste : LATIN CATHOLIC
9. Category : OBC(Non- Creamy)
Name of
10. : Mr. Jeromias S
Father/Guardian
11. Permanent Address : T.S Bhavan, T/C 34/557(1),
Beach Post
office,
Trivandrum
Kerala,
India,
695007
Mobile : 91
12. Phone Land :
9847231114
13. E - Mail : joslienjeromias826@gmail.com
14 Differently abled : NO
Participation in
15. : NO
Sports
Participation in
16. : NO
Cultural Activities
17 Certifiicates :
18 Adhaar card number : 569329050487
19 Guardian's name : Jeromias S
Guardian's
20 : Father
relationship
Exam Reg. No. Year Name of Name of Institution last attended Marks
 Board % Secured Max
Plus Holy Angels Convent Hss
8025934 2021 HSE-Kerala 90.92 1091.0 1200.0
Two Trivandrum
 Statement of Plus Two Marks
Name of Subject Marks Secured Maximum Marks
English 170.0 200.0
Physics 178.0 200.0
Chemistry 179.0 200.0
Computer Science 191.0 200.0
Mathematics 182.0 200.0
Hindi 191.0 200.0
Total Marks 1091.0 1200.0
21. No of time appeared for qualifying examination : 1
22. Preference Details
Choice Programme
B.Sc. Computer Science (Career Related) (Self
1
Financing)
23. Second language to be opted for degree : FRENCH
DECLARATION
The above information is true to the best of my knowledge and I shall abide by the rules and
regulations of the college currently prevailing, which may be amended from time to time.
Place:

Date: Signature of Parent/Guardian Signature of the Candidate

FOR OFFICE USE ONLY

FDP Program to which

: ..................................................................................................
admitted
Language course selected : ..................................................................................................
Admission number : ..................................................................................................
Date of admission : ..................................................................................................

Date: Principal