TAMIL NADU VETERINARY AND ANIMAL SCIENCES UNIVERSITY CHENNAI , TAMIL NADU, INDIA

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TAMIL NADU VETERINARY AND ANIMAL SCIENCES UNIVERSITY CHENNAI - 600 051, TAMIL NADU, INDIA APPLICATION FOR ADMISSION TO BVSc & AH AND BTech (Food Technology) DEGREE PROGRAMMES UNDER NRI / WARDS OF NRI / NRI SPONSORED CATEGORIES 2017-18 (Read the guidelines for admission under NRI / wards of NRI / NRI Sponsored category before filling up the application form) Degree Programme Applied for: (Separate application should be submitted for each degree Programme along with necessary enclosures with appropriate fees) Affix (do not staple) 3.5 x 4.5 cm size recently taken Colour Photograph and sign across without disfiguring the face Bank Draft No. Date Amount (in US dollars) equivalent to INR 2000/- Issuing Bank Registration fee A. DETAILS OF THE CANDIDATE: 1. Name of the Candidate (as in Mark sheet) 2. Address for Correspondence:...... Phone No.(with country code).... Mobile No.. e-mail:.. 3. Gender : Male Female 1

4. Date of Birth : Day Month Year (enclose proof) 5. Place of Birth :.. (enclose proof) 6. Father s Name :. 7. Mother s Name:..... 8. Description of NRI status (Proof to be given as in Specimen I, Ia as applicable) NRI Status NRI Candidate Ward of NRI (Father / Mother) NRI Sponsored Candidate 9. Passport details of NRI / NRI Sponsorer: Name of the NRI / NRI Sponsorer Nationality Passport No. Please tick the category Place and date of issue Date of Expiry 10. Details of Qualifying Examination (From 10 th Standard / Equivalent) Name of the Examination Registration Number Name & Address of the School Name of Board / University and Country Month and Year of Passing Medium of instruction 11. Details of Marks obtained in the qualifying examination (12 th Standard or Equivalent). Attach authenticated transcripts of grades / marks secured in the qualifying examination. (Please enter the subjects studied with marks / grades) S. No. 1 Biology* 2 Botany* 3 Zoology* 4 Physics 5 Chemistry 6 Mathematics 7 English Subject studied Maximum Marks Minimum prescribed marks / grade for a pass Marks / grade # obtained in the Exam TOTAL Percentage of mark in the core subjects will be taken for rank. * as applicable # If the candidate produces grade certificates, he/she has to produce actual marks equivalent to the grades, otherwise only the minimum marks applicable to the grades in the eligible subjects will be taken into account. 2

12. Name & Address of Local Guardian for NRI / Wards of NRI / NRI Sponsored Residence:.... Office: Phone:.. Phone: Mobile:. Fax : e-mail:.. e-mail: B. DETAILS OF NRI SPONSORER (If the sponsorer is other than NRI parents, certificate as per specimen Ia and II should be enclosed) 13. Name of the Sponsorer : 14. Name of the Sponsorer s Father : 15. Relationship of the Sponsorer with the candidate: Brother / Sister/ *Uncle / **Aunt * Uncle Own brother of Father or Mother ** Aunt Own sister of Father or Mother (Strike out which ever is not applicable) 16. (a) Employment details of the sponsorer (Certificate in Specimen III to be enclosed) Designation of the sponsorer Annual Income :... :... Name of the Company / Organisation:... Address (b) If self employed, furnish details :......... :... 17. Residence and Office address of the sponsorer in the residing country Residence:.... Office: Phone:.. Phone: Mobile:. Fax : e-mail:.. e-mail: Signature of the parent/guardian Signature of the applicant Place: Date: 3

CHECK LIST The application should be sent along with the photocopies of the following documents by the NRI / wards of NRI candidates: 1. Recent NRI status certificate of the candidate / parent issued by the Indian Embassy of the Country concerned with their seal as per Specimen-I. 2. Employment Certificate of the NRI parent as per Specimen-III. In the case self-employment, nature of business, annual income and proof thereof. 3. Proof of updated / recent NRI Bank account details and statement of the Parent. 4. Photo copy of the Passport of the NRI candidate /NRI parent 5. Qualifying mark list of the candidate. If grades are produced, certificate issued by competent authority showing equivalent marks to grades should be submitted. 6. Certificate showing that the candidate has undergone the qualifying school education in English medium. 7. Transfer Certificate / Migration Certificate from the school last studied / equivalent certificate. 8. Two Recent Passport size colour photographs (in addition to photo affixed in the application) 9. Proof for date of birth 10. Proof for place of birth and nativity 11. Conduct Certificate issued by the Head of Institution last studied 12. Medical Fitness Certificate from a Registered Medical Practitioner, not below the rank of a Civil Surgeon The application should be sent with the photocopies of the following documents by the NRI sponsored candidates: 1. Relationship certificate showing the relationship of the sponsorer to the candidate as per Specimen-II 2. Recent NRI status certificate of sponsorer sponsoring the candidate issued by the Indian Embassy of the Country concerned with their seal as per Specimen-Ia 3. Employment Certificate of the sponsorer as per Specimen-III. In the case of selfemployment, nature of business, annual income and proof thereof 4. Proof of updated / recent NRI Bank account details and statement of the sponsorer 5. Photocopy of the Passport of the NRI sponsorer 6. HSC (10+2) or Equivalent Examination Mark Sheet 7. Certificate showing that the candidate has undergone the qualifying school education in English medium 8. Transfer Certificate / Migration Certificate issued by the Head of the Institution last studied 9. Two recent passport size colour photographs (in addition to photo affixed in the application) 10. Birth certificate / Proof of Date of Birth of the candidate 11. Nativity Certificate of the candidate 12. Conduct certificate issued by the Head of the institution last studied 12.13. Medical Fitness Certificate from a Registered Medical Practitioner, not below the rank of a Civil Surgeon 4

FORMAT FOR LETTER FROM EMBASSY (In the Letter head of the Embassy office) (NRI certificate of the candidate / parents) SPECIMEN-I No. Dated: CERTIFICATE This is to certify that..., holder of Indian passport No dated....issued at...(place of issue) is residing in this country since He/She is a Non-Resident Indian. (Signature, Designation & seal of the issuing authority) FORMAT FOR LETTER FROM EMBASSY (In the Letter head of the Embassy office) (NRI certificate of the sponsorer) SPECIMEN-Ia No. Dated: CERTIFICATE This is to certify that.... (Sponsorer s Name) holder of Indian passport No. dated.issued at..(place of issue) is residing in this country since.. He/She is a Non-Resident Indian. (Signature, Designation & seal of the issuing authority) 5

SPECIMEN-II FORMAT FOR RELATIONSHIP CERTIFICATE This is to certify that I,... (Name of the sponsorer) son / daughter of.. (Father s Name of the sponsorer) residing at... (Full address of the sponsorer) is his/her 1) Own brother / own sister or 2) Father s own brother (or) Mother s own brother or 3) Father s own sister (or) Mother s own sister of... (Candidate s name), son / daughter of. (Father s name of the candidate) residing at... (Full address of the candidate). Signature of the Tahsildar & Seal 6

SPECIMEN-III FORMAT FOR THE EMPLOYER CERTIFICATE (In the Letter head of the Company / Organization) No. Dated: CERTIFICATE This is to certify that.... (Parent / Sponsorer s name), holder of Indian passport No...... dated.. issued at.... (Place of issue) is an employee of our company / organization since. (Date of joining) in the position of.. (Designation) and drawing a monthly salary of.... admission. This certificate is being issued upon his/her request for the purpose of college (Signature, Designation & seal of the issuing authority) 7

ANNEXURE I DECLARATION BY THE CANDIDATE I,, hereby declare that all the particulars stated in this application and enclosures are true to the best of my knowledge and belief. I have read the Prospectus / guidelines and I shall abide by the terms and conditions therein. I am aware that my admission will be provisional and in the event of me being found ineligible at the time of reporting, my admission will be denied and if I am already admitted, my admission will be cancelled. I am also aware that in all matters concerning admission, the decision of the Tamil Nadu Veterinary and Animal Sciences University, Chennai is final and I shall abide by it. Place : Date : Name: Signature of the Candidate DECLARATION BY THE PARENT/ GUARDIAN I,, hereby declare that all facts given in the application by the Candidate who is my son/ daughter/blood relative are true and correct. In case, any particulars furnished in the application are found to be incorrect at a later stage, I agree to forfeit the admission of my son/daughter/blood relative, no matter, at whatever stage of the course the candidate is at that time. I hereby give an undertaking to pay regularly all his/her dues to the University/Hostel till the completion of his/her course of study. I also undertake the responsibility for his/her good conduct. I am also aware that in all matters concerning admission of my son/daughter/blood relative, the decision of the Tamil Nadu Veterinary and Animal Sciences University, Chennai is final and I shall abide by it. Place : Date: Signature of the Parent /Guardian Name: 8

DECLARATION BY THE SPONSORER FOR THE NRI SPONSORED CANDIDATES I, son / daughter of.... residing at., hereby declare that I am the Father / Mother / Brother / Sister / Uncle (own brother of father or mother) / Aunt (own sister of father or mother) of the candidate I undertake to financially sponsor the above candidate for the entire course of study in Tamil Nadu Veterinary and Animal Sciences University, Chennai. I am also aware that in all matters concerning admission, the decision of the Tamil Nadu Veterinary and Animal Sciences University, Chennai is final and I shall abide by it. Place : Date : Name : Signature of the Sponsorer 9

ANNEXURE-II MEDICAL CERTIFICATE (to be produced at the time of Admission) Certified that I, Dr... (IMC.Reg.No..) have this Day of 2016 examined the candidate whose particulars are given below: 1. Name of the candidate : 2. Name of the parent / guardian : 3. Sex : Male Female 4. Date of Birth : Age (in years) : Date Month Year 5. Identification Marks : 1. 2. 6. Whether the candidate fulfils the : Normal If no, specify the defect following standards? a) General Fitness consists of Complete Blood Test including HIV Test Complete Urine Test Chest X-ray ECG Mental Retardness Test and Other General Tests b) Vision : c) Auditory functions : d) Speech functions : 10

7. Whether Differently abled : (If Yes specify the defect (Physically Handicapped) and the extent of disability) (i) (ii) (iii) (iv) Vision Speech Hearing Limbs (Upper limbs must be normal. More than 70% of disability in lower is not eligible) 8. OPINION: with the above clinical details Please specify, Whether the candidate is Physically eligible to be considered for admission in Tamil Nadu Veterinary and Animal Sciences University, Chennai (if No specify the reasons) Signature of the Candidate Signature of Regd. Medical Practitioner Place : Register No. : Date : Full Address: 11