FOR OFFICE USE ONLY Exam Reg No. Exam Fees Rs, ANNAMALAI , 0a), UNIVERSITY FORM OF APPLICATION FOR, REGISTRATION M.A.,M.Sc., M.Com., M.B.A., M.L.LS., M.P-Ed., B.P-E., B.P.Ed., M.Ed, DEGREE EXAMINATIONS and Diploma, P.GDiploma & Certificate Courses (On Campus Programme) PART -A Course : Branch: Semester: Medium : (English / Tamil) Month : Year: PART -B 1. Name (in Block Letters) ENGLISH TAMIL 2. Father's Name / Occupation 3. Sex M[F 4. Permanent Address (in Block Letters) 5. Regular! Private Student 2 Rae Year of Admission 6. Register Number / Enroll Number 7. Month & Year of Last appearance 8 Are you Registering for Arrear Subjects YES | NO 9. Semester in which you are registering for 1P2]3[s[sTe 10. Write Subject codes in which you are registering ‘SUBJECT CODES Semester PRACTICAL) | THEORY |Saeene VIVA 1 T 1 Ml IV v VI 11. Please Enter Your Elective / Optional Subjects With Subject Code in Block Letters12, _ Particulars Relating to the Previous Semesters (Must be correctly filled in) Month & Year of Passing | Total Marks / Credit point | Whether Passed in the Semester] “with Register Number Secured FIRST Attempt ML Vv VI 13. Details of fees to be paid Amount per Paper | No. of Papers Total Rs. Registration Fee Theory Practical Project viva / Comprehensive viva le Joe |x foe n Mark Sheet per Semester Provisional Certificate S Fine = Membership Fee for Private Candidate Only (per sem.) = Grand Total = 14, Payment Details: ‘Name of the Bank/ Challan / Receipt No Amount University Counter and Date Note: Original Challan / Receipt should be attached with Application Form. 15. _ Incase of SC/ST, if any adjustment of fee to be made in the Scholarship for current semester yES | NO| Station te Date Signature of the Candidate FOR OFFICE USE ONLY PART - A Verified YES/NO. PART - B Verfied YES/NO Head of the Department