ANNA UNIVERSITY : CHENNAI - 600 025

ADMISSION TO B.E. / B.TECH.(PART TIME)

SELF-SUPPORTING DEGREE PROGRAMMES 2015-2016
(FOR WORKING PROFESSIONALS ONLY)
Group Code & Name

: 3

ELECTRICAL

1.

Application Number

: 30511

2.

Name of the Candidate

: SATHYA SWAMINATHAN S

3.

Address for Communication

: 67/44A ALAGIRI NAGAR

4TH STREET,
CHENNAI
TAMIL NADU
VADAPALANI

4.

E-mail ID

: ssathyasam@gmail.com

5.

Mobile No.

: 9884828135

6.

Phone No. (O)

: 044-22706706

7.

Phone No. (R)

:-

8.

Gender

: Male

9.

Date of Birth

: 05-03-1991

10. Presently Employed

: Yes

11. Nationality

: Indian

12. Nativity

: Tamil Nadu

13. Religion

: Hinduism

14. Community & Code

: BC - 25

15. Differently Abled Person

: No

16. Studied IX, X, Diploma in TN : Yes

17. X Std. Register No. Month & Year
:
of Passing

Register No.

Month of Passing

Year of Passing

190613

2006

30511

18. Institution of Study

Class

Year

Name of the Institution

District

State

IX std.

2005

M.S.P.S.N MEMORIAL HSS SCHOOL

DINDIGUL

Tamil Nadu

X std.

2006

M.S.P.S.N MEMORIAL HSS SCHOOL

DINDIGUL

Tamil Nadu

XII std.

--

Diploma

2009

Tamil Nadu
CENTRAL POLYTECHNIC COLLEGE

CHENNAI

Tamil Nadu

19. Diploma Obtained by the Candidate : State Board of Technical Education, TN

20. Diploma Examination Particulars
Diploma Type

: Diploma (Regular)

Register No

: 2730049

Branch Code

: 302

Month and Year of Passing

: 4 / 2009

21. Marks Obtained in the Qualifying Diploma Examination

Semester

Register No.

Passed Year

Marks Obtained

Maximum Marks

2730049

4-2007

1100

1014

II

2730049

4-2007

III

2730049

10-2007

600

578

IV

2730049

4-2008

600

561

2730049

10-2008

600

534

VI

2730049

4-2009

600

476

VII

0-0

VIII

0-0

22. Place of Employment

: LARSEN AND TOUBRO SHIPBUILDING, MANAPAKKAM

District

: CHENNAI

Distance

: 8 KM

23. Details of Employment including: present employment

Organisation Name

TNGST/CST/TIN/TAN

GPF/CPS/PF No.

LARSEN AND TOUBRO SHIPBUILDING

032347

TN/84091/066

24. Employment Service Details

Designation

Period of Service

Duration of Service

SENIOR ENGINEER

7-12-2009 to 23-11-2015

5- Years 11- Months 16- Days

0-0-0 to 0-0-0

0- Years 0- Months 0- Days

0-0-0 to 0-0-0

0- Years 0- Months 0- Days

0-0-0 to 0-0-0

0- Years 0- Months 0- Days

0-0-0 to 0-0-0

0- Years 0- Months 0- Days

Total in Months

71

25. Payment Details

Mode of Payment

: Net Banking

Amount

: Rs. 600

Transaction ID

: 30511565383794261f

The information furnished above are true to the best of my knowledge and belief.

Signature of the Candidate

ANNA UNIVERSITY : CHENNAI - 600 025

ADMISSION TO B.E./B.TECH. (PT) SELF SUPPORTING DEGREE PROGRAMMES 2015-16
(FOR WORKING PROFESSIONALS ONLY)

Group Code

Group Name

ELECTRICAL

To
THE DIRECTOR
CENTRE FOR ADMISSIONS
ANNA UNIVERSITY
CHENNAI - 600 025.

From
SATHYA SWAMINATHAN S
67/44A ALAGIRI NAGAR
4TH STREET,
VADAPALANI
9884828135

30511