Annexure –22

îI›ï£´ Fø‰îG¬ôŠ ð™è¬ô‚èöè‹

TAMIL NADU OPEN UNIVERSIT Y
[A state Open Universit y Established by Government of Tamil Nadu,
Recognized by UGC & DEB, Member in Asian Association of Open
Universities & Association of Commonwealth Universities]
577, Anna salai, Saidapet, Chennai - 600015.
ªî£¬ô«ðC- - 044 - 24306645
Web site: www.tnou.ac.in
APPLICATION FOR PERSON STUDIED IN TAMIL MEDIUM (PSTM) /
PERSON STUDIED IN ENGLISH MEDIUM (PSEM)
01. Enrollment No:
«ê˜‚¬è â‡:
02. Name of the Student:
ñ£í£‚è˜ ªðò˜:
Door/Plot No:
èî¾/ñ¬ù â‡:

Street / ªî¼
03. Address:
ºèõK: Village / Aó£ñ‹

Taluk / õ†ì‹

District / ñ£õ†ì‹ PIN

04. Mobile No:
ܬô«ðC â‡:
05. Details of Qualifying Examination Passed:
î°F ªðŸø «î˜M¡ Mõóƒèœ:
i) Name of the Programme :
ii) Month & Year of Passing :
iii) Medium :
iv) Folio Number of Provisional Certificate :

06. Details of Fee Paid:

ªê½ˆFò è†ìí Mõóƒèœ:
DD / Transaction id Date Name of the Bank Amount

Station:
Date: Signature of the Applicant
FOR OFFICE USE ONLY

INSTRUCTIONS TO THE APPLICANTS M‡íŠðî£ó¼‚è£ù ÜP¾Áˆî™èœ

The fee for PSTM / PSEM Certificate can be paid through PSTM / PSEM ꣡Pî› ªðÁõîŸè£ù ªî£¬è¬òˆ
Demand Draft from any one “îI›ï£´ Fø‰îG¬ôŠ ð™è¬ô‚èöè‹”
of the Nationalised Banks in favour of “Tamil Nadu Open ªê¡¬ù â¡ø ªðòK™ ã«î‹ å¼
University” payable at Chennai. «îCòñòñ£‚èŠð†ì õƒAJ™ ªðøŠð†ì
Fee: PSTM / PSEM: Rs.300/- õƒA õ¬ó«õ£¬ô Íôñ£è ªê½ˆ¶î™ «õ‡´‹.
PSTM / PSEM: Rs.300/-

Application form should be sent to: M‡íŠð‹ õ‰¶«êó «õ‡®ò ºèõK:

The Controller of Examinations «î˜õ£¬íò˜
Tamil Nadu Open University îI›ï£´ Fø‰îG¬ôŠ ð™è¬ô‚èöè‹
577, Anna Salai, Saidapet, 577 Ü‡í£ ê£¬ô, ¬ê«ð†¬ì,
Chennai - 600 015. ªê¡¬ù -- 600 015.
For further Details: 044-24306665 «ñ½‹ MõóƒèÀ‚°: 044--24306665