SRIMATHI SUNDARAVALLI MEMORIAL ARTS AND SCIENCE COLLEGE

New Perungalathur, Chennai - 600 063

Registration Form

Personal Details

________

Name of the Student

Date of Birth

Gender
Male Female

Differently abled person
Yes No

Religion

Nationality

Community

Residential Address

Residential Pincode

Student Mobile No.

Student Email ID

Student Aadhaar No.

Course Preferred 1

Course Preferred 2

Course Preferred 3

Class X Details

________

Name of the School

Board

Medium

Year of passing

Mark obtained

Percentage/CGPA

Class XII Details

________

Name of the School

Board

Medium

Year of passing

Mark obtained

Percentage/CGPA

Father Details

________

Name

Mobile No.

Email ID

Mother Details

________

Name

Mobile No.

Email ID

Other Details