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UNIVERSITY ACCOUNTS COPY

BANK COPY

CHENNAI CAMPUS

STUDENTS COPY

CHENNAI CAMPUS

CHENNAI CAMPUS

Vandular Kelambakkam Road, Chennai 600 048.

Vandular Kelambakkam Road, Chennai 600 048.

Vandular Kelambakkam Road, Chennai 600 048.

Date .
Registration No : _______________________
Course : _____________________________
Branch : _____________________________
Year of Fees : ________________________
Name (Capital Letters): _________________
SB A/C No ___________________________

Date .

Date .

Registration No : _______________________

Registration No : _______________________

Course : _____________________________

Course : _____________________________

Branch : _____________________________

Branch : _____________________________

Year of Fees : ________________________

Year of Fees : ________________________

Name (Capital Letters): _________________

Name (Capital Letters): _________________

UNIVERSITY

UNIVERSITY

HOSTEL FEE

HOSTEL FEE

Amount
(Rs.)

Fees Particulars

Tuition Fees

Mess & other charges - Veg / Non Veg / Special


Additional Fees
Caution Deposit

Amount
(Rs.)

Fees Particulars

Hostel Establishment Charges

Hostel

Amount
(Rs.)

Fees Particulars

Tuition Fees

Tuitions Fees

Hostel Establishment Charges

Hostel Establishment Charges

Mess & other charges - Veg / Non Veg / Special

Mess & other charges - Veg / Non Veg / Special

Electricity Charges for A/C


NAME OF THE CLUB:
CLUB A/C NO:
____________________
____________________
OTHERS (specify) ____________________

Double Bedded
A/c
Non A/c

Rupees

Triple Bedded
A/c
Non A/c

Four Bedded
A/c
Non A/c

Six Bedded
A/c

Non
a/c

Ps

1000 X
500 X

Double Bedded
A/c
Non A/c

Triple Bedded
A/c
Non A/c

100 X

Six Bedded
A/c

Non
a/c

Total

50 X

Total

Demand Draft No Amount

Total
Demand Draft No Amount
Bank and Branch ..
Amount in words (Rupees.....
....Only)

Bank and Branch ..

Demand Draft No Amount

Amount in words (Rupees.....


....Only)

Bank and Branch ..

Manager

Amount in words (Rupees.....


....Only)

Signature of Remitter
Signature of Remitter

Four Bedded
A/c
Non A/c

Additional Fees
Caution Deposit
Hostel
Electricity Charges for A/C
NAME OF THE CLUB:
CLUB A/C NO:
____________________
____________________
OTHERS (specify) ____________________

Additional Fees
Caution Deposit
Hostel
Electricity Charges for A/C
NAME OF THE CLUB:
CLUB A/C NO:
____________________
____________________
OTHERS (specify) ____________________

Total
Notes

 Tick whichever is applicable

 Tick whichever is applicable

Manager

Signature of Remitter

Manager

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