KHADIR MOHIDEEN COLLEGE

[CO-EDUCATION]
[NATIONALY RE-ACCREDITED WITH B GRADE BY NAAC]
[AFFILIATED TO BHARATHIDASAN UNIVERSITY, TRICHY]
ADIRAMPATTINAM-614 701, THANJAVUR(Dt)

APPLICATION FORM FOR ADMISSION

UNAIDED COURSES(UG)
Degree:B.Com. Application No: OLSF-00008
Major:Commerce Registration No:
Paid ID: MOJO1731105N51439899
Paid Amount:
107.08

1. Name: SHEIK MUHIBULLAH H

2. Date of Birth: 04/09/2003

3. Father's Name: HITHAYATHULLAH

4. Father's Occupation: FARMER

5. Mother's Name: JANNATH

6. Mother's Occupation: HOMEMAKER

7. Gender: Male

8. Place of Birth: KADAYANALLUR

9. Contact Number(Mobile): 9342500164

10. Nationality: Indian

11. Religion: Muslim

12. Community: BCM

13. Caste: LEBBAI

14. Annual Income: 96000

15. Aadhar Number: 235674813927

16. Bank Account Details: 3412020100

17. Permanent Address: VADAKARAI

18. Whether Hostel Required(Girls Only): Yes

19. Name of the Local Guardian(for hosteler): NIL

20. Physically Challenged? : No Details(if yes) : NIL

21. Son/Daughter of Ex.serviceman of Tamilnadu Origin? : No

Troupe No. & Rank (if yes) : NO
22. Tamil Origin from Andaman and Nicobar Islands ? : No
 23. Name & Address of the Institution last studied: ROTARY CLUB MATRIC HR SEC SCHOOL MAYILAD
24. Qualifying Examination Passed
specify the University/Board : Tamilnadu State Board

25. Details of Marks in the Main / Core Subjects for Degree Course

Sl Subject Marks Obt. Max Marks Month & Year of Passing Register No No. of Attempts
1 Tamil 79 100 MAY 2021 2016481174 1
2 English 74 100 MAY 2021 2016481174 1
3 ECONOMICS 76 100 MAY 2021 2016481174 1
4 COMMERCE 74 100 MAY 2021 2016481174 1
5 ACCOUNTANCY 79 100 MAY 2021 2016481174 1
6 COMPUTER APPLICATION 79 100 MAY 2021 2016481174 1
7 Total 461 600

26. Distinction in Sports/NCC/NSS/Other Extra-Curricular activities

Sl Activities Level of Participation Awards/Commendations
1 NO NIL NIL

I declare that the particulars furnished above are true and correct.
I submit that I will abide by the rules and regulations of the College.
Place:
Date :31/07/2021 Signature of the Student

FOR OFFICE USE ONLY

Received and Registered on :__________________________________________________________________

Interview Date :_______________________________ Fees Paid :_____________________________

Certificates Verified

 HSC MARKSHEETS  COMMUNITY CERTIFICATE

 TRANSFER CERTIFICATE  CONDUCT CERTIFICATE

 SPECIAL CATEGORY CERTIFICATE  ELIGIBLITY CERTIFICATE

Signature of the Staff who processed the Applicaiton:

NOT ADMITTED PROVISIONALLY ADMITTED ADMITTED

PRINCIPAL