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ANNEXURE – I

ANNA UNIVERSITY CHENNAI, CHENNAI – 600 025


CENTRE FOR UNIVERSITY – INDUSTRY COLLABORATION

TAMIL NADU STATE LEVEL PLACEMENT PROGRAM (TNSLPP)


2009 – 2010

REGISTRATION FORM
Name: _______________________________ Sex: _________
Reg. No: _______________________________
Branch: _______________________________
College: _______________________________________________
Date of Birth: _______________________________ Age: __________
Residential Address: __________________________________________
__________________________________________
__________________________________________
Phone No: _______________________ Mobile: __________________________
E-Mail Id: ________________________
Academic Profile:

Course SSLC HSC Diploma (For B.E


  Lateral Entry) (Upto 7 th Sem)
Percentage
       
Month / Year of Passing
       

Semester 1 2 3 4 5 6 7 Average
% of Marks
               

Draft No: _______________ Dated : _________________ Bank : __________________________

I hereby declare that the information’s provided above, are true to best of my knowledge.

Student’s Signature

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