Page 1

Application No UGR222552
CHURCH OF SOUTH INDIA - DIOCESE OF TIRUNELVELI
Sarah Tucker College (Autonomous), Tirunelveli-7
Nationally Assessed and Reaccredited with A+ Grade
Tirunelveli - 627 007
Applied for : Aided - BA Economics

1. Name : MUTHU ABINAYA D

2. Aadhaar Number : 953746702120
3. DOB / Age : 17-06-2005
4. Sex : Female
5. Community : OC
6. Caste : Vellair
7. Religion : HINDU
8. State/Nationality : TAMIL NADU / INDIAN
9. Name & Occupation of
: DAKSHINAMOORTHY / Other ( Medical Salesman )
Father / Guardian
10. Name & Occupation of
: MUTHULAKSHMI / House-wife
Mother
11. Annual Income : Rs.150,000.00
12. Address & Pincode : 3, ILANGOVADIGAL STREET, KOKKIRAKULAM, PALAYAMKOTTAI,
TIRUNELVELI, TAMIL NADU, INDIA - 627009
13. Mobile / Phone : 9942084697
14. Email Id : abinaya123@gmail.com
15. Blood Group : B-
16. Whether the applicant is willing to donate blood ? : Yes
17. Whether the applicant is Differently abled ? : No
18. Whether the applicant is daughter of Ex-Serviceman ? : No
19. Whether the applicant is Tamil Origin from Andaman Nicobar/Sri Lanka ? : No
20. Whether the applicant is migrated from Jammu and Kashmir ? : No
21. i) Distinction in Sports ? : No
ii) Distinction in NCC ? : No
iii) Distinction in NSS ? : No
ST IGNATIUS CONVENT HR SEC SCHOOL -
22. School Name & Place :
PALAYAMKOTTAI
23. Mention the Qualifying Examination Passed. HSC or equivalent (Academic Stream / Vocational
Stream)
Subject Marks Scored Maximum Marks Month & Year of Passing Register.No No.of Attempts
Tamil 79.00 100 April/2022 5044936 1
English 58.00 100 April/2022 5044936 1
History 63.00 100 April/2022 5044936 1
Economics 81.00 100 April/2022 5044936 1
Commerce 90.00 100 April/2022 5044936 1
Accountancy 75.00 100 April/2022 5044936 1
Total 446.00 600
Cut off out of 400 309.00
Page 2

Application No UGR222552

DECLARATION
I declare that all the particulars furnished above are true and correct. I submit that I will abide by the rules and
regulations of the College, if admitted.
Place :
Date : Signature of the Father / Mother / Guardian Signature of the Applicant

Note: Copy of Mark Statement, Transfer Certificate, Community Certificate, Aadhaar Card and Special Category
Certificates (if applicable) to be enclosed with the application.

For Office use only

PAYMENT DETAILS
Ref.No & Date 111562131706 / 2022-07-08 07:32:05
Amount 50.00

Certificates Verified
XI Marksheet
HSC Marksheet
Transfer Certificate
Community Certificate
Conduct Certificate
Aadhaar Card
Sports
NSS
NCC
Special Category I
Special Category II

Full Signature of Staff who processed the Application

Full Signature of Senior Staff in the Department

Receiver's Signature & Date : _____________________________________

ADMISSION STATUS

Application No : UGR222552
Application Date : 08-07-2022

Status : Admitted / Not Admitted

Interviewed on : ____________________________

Interviewed by : ____________________________

Signature :