KHADIR MOHIDEEN COLLEGE

[CO-EDUCATION]
[NATIONALY RE-ACCREDITED WITH B GRADE BY NAAC]
[AFFILIATED TO BHARATHIDASAN UNIVERSITY, TRICHY]
ADIRAMPATTINAM-614 701, THANJAVUR(Dt)

APPLICATION FORM FOR ADMISSION

AIDED COURSES(UG)
Degree:B.Com. Application No: OLA-00029
Major:Commerce Registration No:
Paid ID: MOJO1719905N32829355
Paid Amount:
55.31

1. Name: ABDUL ALI M

2. Date of Birth: 19/04/2003

3. Father's Name: MAKBOOL AHAMED

4. Father's Occupation: Farmer

5. Mother's Name: AYISHA BANU

6. Mother's Occupation: House Wife

7. Gender: Male

8. Place of Birth: SHIFA HOSPITAL LALPETTAI

9. Contact Number(Mobile): 8300507446

10. Nationality: Indian

11. Religion: Muslim

12. Community: BCM

13. Caste: Labbai

14. Annual Income: 6000

15. Aadhar Number: 967869389664

16. Bank Account Details: 924812298 Indian Bank Ayangudi

17. Permanent Address: 446,Arafath Street,Kattumannarkoil Taluk,Melpakkathurai,Ayangudi,Cudd

18. Whether Hostel Required(Girls Only): No

19. Name of the Local Guardian(for hosteler):

20. Physically Challenged? : No Details(if yes) :

21. Son/Daughter of Ex.serviceman of Tamilnadu Origin? : No

Troupe No. & Rank (if yes) :
22. Tamil Origin from Andaman and Nicobar Islands ? : No
 23. Name & Address of the Institution last studied: PRG HIGHER SECONDARY SCHOOL,Udayarkudi Ro
24. Qualifying Examination Passed
specify the University/Board : Tamilnadu State Board

25. Details of Marks in the Main / Core Subjects for Degree Course

Sl Subject Marks Obt. Max Marks Month & Year of Passing Register No No. of Attempts
1 Language 066 100 07/2021 1
2 English 066 100 07/2021 1
3 History 065 100 07/2021 1
4 Economics 064 100 07/2021 1
5 Commerce 069 100 07/2021 1
6 Accountancy 069 100 07/2021 1
7 Total 399 600

26. Distinction in Sports/NCC/NSS/Other Extra-Curricular activities

Sl Activities Level of Participation Awards/Commendations
1

I declare that the particulars furnished above are true and correct.
I submit that I will abide by the rules and regulations of the College.
Place:
Date :19/07/2021 Signature of the Student

FOR OFFICE USE ONLY

Received and Registered on :__________________________________________________________________

Interview Date :_______________________________ Fees Paid :_____________________________

Certificates Verified

 HSC MARKSHEETS  COMMUNITY CERTIFICATE

 TRANSFER CERTIFICATE  CONDUCT CERTIFICATE

 SPECIAL CATEGORY CERTIFICATE  ELIGIBLITY CERTIFICATE

Signature of the Staff who processed the Applicaiton:

NOT ADMITTED PROVISIONALLY ADMITTED ADMITTED

PRINCIPAL