GOVERNMENT OF TAMIL NADU

DIRECTORATE OF TECHNICAL EDUCATION

TAMIL NADU ENGINEERING ADMISSION - 2023 (B.Arch Course)
Application for Admission to B.Arch Degree Course
Application Number: 101397

Personal Information
Name: B.Dhanavarshini Name of the Parent/Guardian: K.Balakrishnan
Communication Address: 1D3 Jothinagar, 4th Street, Kovilpatti, Tuticorin. Permanent Address: 1D3 Jothinagar, 4th Street, Kovilpatti, Tuticorin
State: Tamil nadu District: Thoothukudi
Taluk: Kovilpatti Communication address pincode: 628501
Native District: Thoothukudi Civic status of Native Place: Municipality
Date of Birth (DD-MM-YYYY): 08-08-2005 Gender: Female
Mother Tongue: Tamil Nationality: Indian
Nativity: Tamil nadu Religion: Hindu
Name of the Community: BC Name of the Caste: Nadar, Shanar and Gramani
Aadhar Number (optional): 867703001102

Special Reservation Information

Whether you are a candidate under quota for Eminent Sports person as per Ex-Servicemen (Only Army/Navy/ Air force services are Eligible): No
annexure-II, item No.22 of information brochure?:
No
Differently Abled Person: No Differently Abled Type: --
TFC Center for certificate verification:
Bharathiyar Centenary Memorial Women’s Polytechnic College, Ettayapuram – 628902.

Scholarship Information
Parent Occupation: Business Annual Income: 250000
Are you a First Graduate?: Yes Post Matric Scholarship (SC/SCA/ST/Converted Christians): No

School of Study Information

Category of School: Private Civic status of school location (+2 or Diploma): Municipality
Have you studied VIII to XII in Tamil Nadu?: Yes Have you studied from VI to VIII in private school under RTE and IX to XII
in Government School?:
No
Studied Diploma ( 10 + 3): No Have you studied VI to XII in Government school?: No

Class Year of Passing Name of the school/college District State Block School of study

VI Std. 2017 Kamaraj Matric Hss, Kovilpatti Thoothukudi Tamil nadu Kovilpatti --

VII Std. 2018 Kamaraj Matric Hss, Kovilpatti Thoothukudi Tamil nadu Kovilpatti --

VIII Std. 2019 Kamaraj Matric Hss, Kovilpatti Thoothukudi Tamil nadu Kovilpatti --

IX Std. 2020 Kamaraj Matric Hss, Kovilpatti Thoothukudi Tamil nadu Kovilpatti --

X Std. 2021 Kamaraj Matric Hss, Kovilpatti Thoothukudi Tamil nadu Kovilpatti --

XI Std. 2022 Kamaraj Matric Hss, Kovilpatti Thoothukudi Tamil nadu Kovilpatti --

XII Std. 2023 Kamaraj Matric Hss, Kovilpatti Thoothukudi Tamil nadu Kovilpatti --

Academic Information
Qualifying Examination: HSC Name of the Board of Examination: Tamil nadu Board of Higher Secondary Education
Permanent register number: 2212068972 HSC Roll number: 7069038
Qualified Year: 2023 HSC Group: HSC Academic
Group Code: Physics/ Chemistry/ Maths/ Biology Medium of Instruction: English
NATA1 Roll/Register Number: -- NATA1 Obtained mark: --
NATA2 Roll/Register Number: 232168113643 NATA2 Obtained mark: 114
NATA3 Roll/Register Number: 232168113643 NATA3 Obtained mark: 97
HSC maximum (total) marks: -- HSC obtained marks: --
SSLC maximum (total) marks: -- SSLC obtained marks: --
Have you applied for NEET ?: No Have you applied for JEE ?: No
JEE Application Number: -- JEE Session 1 Roll Number: --
JEE Session 1 Obtained percentile mark: -- JEE Session 2 Roll Number: --
JEE Session 2 Obtained percentile mark: -- Educational Management Information System(EMIS) Number: 2007005822
 GOVERNMENT OF TAMIL NADU
DIRECTORATE OF TECHNICAL EDUCATION
TAMIL NADU ENGINEERING ADMISSION - 2023 (B.Arch Course)
Application for Admission to B.Arch Degree Course
Application Number: 101397

Community certificate number: E8BF698E6A687C86 Nativity certificate number (if applicable): --

 GOVERNMENT OF TAMIL NADU
DIRECTORATE OF TECHNICAL EDUCATION
TAMIL NADU ENGINEERING ADMISSION - 2023 (B.Arch Course)
Application for Admission to B.Arch Degree Course
Application Number: 101397

DECLARATION BY THE APPLICANT

I, B.DHANAVARSHINI (Son / Daughter) of K.BALAKRISHNAN hereby solemnly declare that the information furnished and the statements
given in the application and the enclosures are true, correct and complete. I further declare that should it be found otherwise, I will be liable
to forfeit my seat and / or removal from the rolls of the Institution at whatever stage of study I may be, besides making me liable for criminal
prosecution. I am fully aware that as per the directions of the Hon'ble Supreme Court of India and Tamil Nadu Prohibition of Ragging Act
1997, Ragging is an offence, as is banned in the Institutions and anyone indulging in ragging is liable to be punished such as expulsion from
the Institutions and / or rigorous imprisonment up to 3 years, and / or fine up to Rs.25,000/-

Place:

Date: ( Signature of the Applicant )

DECLARATION BY THE PARENT/ GUARDIAN

I, K.BALAKRISHNAN (Parent / Guardian) of B.DHANAVARSHINI hereby solemnly declare that I am fully aware of the declaration made
by the applicant, and I declare and bind myself on the same terms contained in the above declaration. The statements and the information given
are true, correct and complete. If it is found otherwise, the applicant is liable to forfeit the seat and / or removal from the rolls of the Institution
at whatever may be the stage of study, besides making me liable for criminal prosecution I am fully aware that as per the directions of the
Hon'ble Supreme Court of India and Tamil Nadu Prohibition of Ragging Act 1997,Ragging is an offence, as is banned in the Institutions and
anyone indulging in ragging is liable to be punished such as expulsion from the Institution and / or rigorous imprisonment up to 3 years, and /
or fine up to RS. 25,000/-

Place:

Date: ( Signature of Parent / Guardian )

Note: Guardian can execute the above declaration, only if both the parents are not alive.
 GOVERNMENT OF TAMIL NADU
DIRECTORATE OF TECHNICAL EDUCATION
TAMIL NADU ENGINEERING ADMISSION - 2023 (B.Arch Course)
Application for Admission to B.Arch Degree Course
Application Number: 101397

The following Certificates copy have to be uploaded to our system.

1. Transfer certificate
2. 10th Mark Sheet
3. 12th Mark Sheet or Diploma Mark sheet as applicable
4. NATA Mark sheets as applicable
5. Permanent Community Certificate Card for BC (Permanent card / Electronic form / Digitally Signed E-Certificate)
6. Income Certificate of the Parent
7. Special Reservation Form for Sports and relevant certificates
8. Special Reservation Form for Ex-Serviceman and relevant certificates
9. Special Reservation Form for Blindness & Low Vision and relevant certificates
10. Bonafide Certificate for Government School studied students