Sex : MALE FEMALE Date of Birth : 2 Sri Ramajayam No. 13 SASTRA UNIVERSITY (A University under section 3 of the UGC Act, 1956) SRINIVASA RAMANUJAN CENTRE Lakshmi Vilas Agraharam, Kumbakonam - 612 00 Tamil Nadu. APPLICATION FOR ADMISSION TO B.Sc. / B.B.A. / B.C.A. / B.Com. / B.Ed. / M.Com. / M.Sc. / M.Ed., & M.Sc., B.Ed., / M.A., B.Ed., PROGRAMMES 2013-14 (To be filled by the applicant in capital letters) Applicant s Name :... (as in Qualifying Examination marksheet) 2 (a) Father s Name : Shri... (b) Mother s Name : Smt... (c) Guardian s Name (If Father not alive) :... 3 Address for communication :... with pin code...... Pin :... District :... State :... Ph :... STD Code :... Email :... Date Month Year Age as on : 002013 Parent s Occupation :... 7(a). Nationality :... 7(b). Religion... 8(a). Name of the Caste :... 8(b). Community : BC MBC SC ST DNC OC Programme applying for : B.Sc. B.B.A B.C.A. B.Com. B.Ed., M.Com. M.Sc. M.Sc. B.Ed., M.A., B.Ed., M.Ed., Course applying for : I Choice... (B.Sc./ M.Sc. B.Ed., / M.Sc. / M.A., B.Ed., applicants only) II Choice... III Choice... 1 Qualifying Examination Passed :... (a) Month and Year of Passing :... (b) Name of the School / College :... & Address :...... (c) Name of the Board / University:... (d) Registration No(s). with Month and year of Last Appearance :... 1 (Compulsory)
1 / Grades obtained : In +2 Examinations ACADEMIC Language... English Elective... / Grades obtained in qualifying Degree Course (For PG applicants only) UG Degree obtained :... Branch of study :... I SEMESTER II SEMESTER For online applications only: Please enclose Demand Draft for Rs. 300/- favouring SASTRA University payable at Kumbakonam Name of the Bank... Branch:... D.D. No... Date :... 2
III SEMESTER IV SEMESTER V SEMESTER VI SEMESTER Overall percentage :... If VI semester results are not declared, aggregate marks till V semester shall be considered for the purpose of provisional admission. 3
GENERAL INSTRUCTIONS The name you provide will appear identically on all official documents. Indicate your permanent address. Your permanent address is a stable address, which will be valid for a long period of time. This is the address where you may be reached, even if your mailing address changes. Indicate the phone number, fax number and the email address. Indicate your qualifying examination passed, year of passing, register number, number of appearances and the marks obtained in the qualifying examinations. copies of the mark sheet should be enclosed. Original should be submitted during the time of counselling and admission. Kindly enclose 3 passport size photographs. (One each to be affixed in the application form and in the Index card and the remaining to be attached with name and application number written at the back). Along with the originals, the candidiates are requested to bring 3 attested copies of Transfer Certificate, Conduct Certificate, Community Certificate, X and XII Mark statement (for UG admission) and degree consolidated mark statement and Provisional / Degree Certificate (for PG admission). Fees once paid will not be refunded under any circumstances. The candidate should pay the entire Programme fee minus whatever has been already paid, if he / she discontinues the programme any time after its commencement. SASTRA reserves its right not to conduct a programme, if the response to that particular programme is not sufficient. SASTRA wishes that there be no dispute on any account. However if there is any dispute the jurisdiction will be Thanjavur, Tamil Nadu. Ragging is a cognizable offence and any form of ragging either inside or outside the campus is totally prohibited. Indulging in ragging will result in expulsion from the University and/or imprisonment up to three years and/or fine up to Rs.25,000/-. Last date for submission of completed application form for UG / PG programme is 10201 JOINT DECLARATION BY THE APPLICANT AND PARENT I hereby solemnly and sincerely affirm that the statement made and the information furnished by me in the application as also in enclosures thereto submitted by me are true. Should it, however, be found that any information furnished therein is untrue in material particulars or on verification at a later stage, I am liable for criminal prosecution and I also agree to forego my seat in this Institution / for the removal of my name from the rolls of the institution at whatever stage of study I may be at the time of detection of such wrong particulars. I am also fully aware of the general instructions and I am bound by the same. Place : Date : Signature of the Candidate I am fully aware of the above declaration and I have understood the same. I agree to the above conditions. Place: Date : Signature of the Parent / Guardian Note: The guardian can execute the above declaration, only if both the parents are not alive. 4
Srinivasa Ramanujan Centre, Lakshmi Vilas Agraharam, Kumbakonam - 612 00 STUDENT S INDEX CARD B.Sc./ B.B.A. / B.C.A. / B.Com / B.Ed., / M.Com / M.Sc. / M.Ed. / M.A. B.Ed. / M.Sc. B.Ed., ( ) Degree Admission 2013-14 Application No. Register No. (Office use only) : Academic Details : SASTRA UNIVERSITY (TO BE FILLED BY THE APPLICANT IN BLOCK LETTERS) Name :... Sex :... Date of Birth :... Father s Name : Shri... Mother s Name : Smt... Guardian s Name :... Relationship with student :... Occupation of Father / Guardian Name of the Organisation :... Designation :... Father/Guardian s Annual Income :... Nationality :... Name of the Religion :... Name of the Caste :... Community : BC/OBC/MBC/SC/ST/OC State :... Occupation of Mother Name of the Organisation :... Designation :... Mother s Annual Income :... Ph No : With STD Code (Off) :... (Resi) :... Mobile :...,... E-mail :... (Parent) (Student) (Parent) (Student) Qualifying Exam Passed :... University / Board of Study :... Institution/School Name :... Register No. :... No. of Appearance(s) :... Month & Year of Passing :... Overall Percentage CGPA :... Class obtained :... For PG applicants only Overall Percentage :... Class obtained :... Affix Student s (Compulsory) Affix Father s (Compulsory) Affix Mother s (Compulsory) Affix Guardian s Signature of the Student Signature of the Parent Signature of the Guardian 5
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FEE DETAILS Name of the course Tuition fees per semester (Rs) Special fees, Registration fees etc. (One time payment at the time of admission) (Rs) B.Sc., B.B.A, B.C.A, B.Com., 7,500 4,750 B. Ed., 35,000 4,750 M.Ed., 40,000 4,750 M.Com. & M.Sc. Programmes 10,000 4,750 M.Sc. B.Ed., / M.A., (English Literature) B.Ed., (5 Year Integrated Programme) 10,000 4,750 Completed forms must be mailed in the envelope enclosed to: OFFICE OF ADMISSIONS SASTRA UNIVERSITY SRINIVASA RAMANUJAN CENTRE Lakshmi Vilas Agraharam, (Near State Bank Colony) Kumbakonam - 612 001, Tamil Nadu Ph : 0435-2426823 / 2400822 / 2421547 Fax : 2402460 7
Bachelor of Science (B.Sc.) in : Communication & Computer Science Electronics & Computer Science Mathematics & Computer Science Physics & Computer Science Bio Chemistry with DMLT COURSES OFFERED: Bachelor of Business Administration (B.B.A.) Bachelor of Computer Application (B.C.A.) Bachelor of Commerce (B.Com.) Eligibility : A pass in +2 (or) its equivalent examinations from a recognised board or its equivalent Master of Commerce (M.Com.) in : Eligibility : A valid B.Com. / B.A., (Corp. Sec) / B.B.A., degree from a recognised university Master of Science (M.Sc.) in : Mathematics Bio Chemistry Applied Electronics and Electronics & Instrumentation (E&I) Computer Science Microbiology Eligibility : A valid UG degree in related discipline from a recognised university Bachelor of Education (B.Ed.) (English, Tamil, Mathematics, Physical Sciences, Biological Sciences, Economics, Commerce, Computer Science, History and Geography) Eligibility : A valid Bachelor s degree from a recognised university with 45% aggregate. Master of Education (M.Ed.) Eligibility : Degree in Education from a recognised University Five year integrated M.Sc. B.Ed. (Mathematics / Computer Science) / M.A., (English Literature) B.Ed., Eligibility : A pass in +2 (or )its equivalent examinations from a recognised a board with the major subject of study 8