Islamiah Women'sArts & Science College
To be filled in by the office Received on
Interview Card Sent on
Date of Interview
Admission Card No
Application Form
Serial No. (Quote this number in all communications)
Passport size photo(.jpg only) *
1. Course for which Application is made (INDICATE THE COURSE IN THE TEXT BOX)*
2. (a) Name in full (Block Letters) *
2. (b) Father's Name *
3. Date of birth and age (on July 15 of the year of admission) Proof of the age to be furnished *
3. (a) Date of Birth *
3. (b) Age *
3. (c) Year *
3. (d) Month *
3. (e) Days *
4. (a) Nationality *
4. (b) Religion *
4. (c) Caste *
4. (d) Community * Forward Backward Most Backward Scheduled Caste/Tribe
5. College last Studied with dates of admission and withdrawal *
5. (a) College details *
5. (b) Joining date *
5. (c) TC Received date *
6. Qualifying Degree *
6. (a) University * Thiruvalluvar Other(Please Specify)
6. (b) College Studied *
6. (c) Year *
7. Educational Particulars
Total Marks of (a) (b) & (c) of Core Courses: Class obtained in Core Courses
8. Whether the qualifying Examination has been passed at first appearance if not, give details of appearance in each case * Yes No
9. Name of Father/Guardian (if father is not alive) *
9. (a) Occupation *
9. (b) Annual Income *
10. Name of Mother *
10. (a) Occupation *
10. (b) Annual Income *
11. The State, District and Village to which the candidate belongs and permanent address for further communication. *
12. Was the Candidate in receipt of fee concession or scholarship last year ? if so, full particulars should be give with certificate from the head of the institution last studied * Yes No
13. Whether any defects were noticed by the medical officer at the last medical inspection and whether they have have been remedied? Has the candidate been vaccinated or had small pox ?* Yes No
14. Has the candidate studied any P.G. Course previously and appeared for the examination conducted by Thiruvalluvar or any other University. If so, details should be given* Yes No
15. Does the candidate wish to join the Hostel ?* Yes No
16. Any special information the candidate desires to furnish for being considered for admission to the College *
17. Was the candidate in any service previously? The nature of the job and total years of experience should be stated* Yes No
DECLARATION BY THE CANDIDATE I declare that my admission is at my own risk and is provisional and is subject to the approval of the Thiruvalluvar University. If for any reason, my admission is not approved I shall not hold the College responsible for it. I also declare that the particulars given above are correct and I shall continue the course for the full two academic years, if selected. In the event of my leaving College after admission any time before completing the course,fees for the rest of the course will be paid by me as per rules in force to get back my certificates. I agree to the nomination of the Office - bearers of the College Union and the Secretaries of the Subject Associations by the Principal. I hereby promise that I will not demand or ask for the election of the Office - bearers of my immediately the College Union and the Secretaries or the Subject Associations and I will not join any agitation for the same. T.C may immediately be given to me if i misbehave or contravene any of the rules of the College/Hostel.
Place* Date*
Signature of the candidate (.jpg only) *