St. Josephs College (Autonomous) Nationally Re- Accredited with A+ Grade Tiruchirappalli - 620 002. Tamilnadu, India. APPLICATION FOR memory access - UG (SHIFT-I) 2012-2013 act Number : Disposal: Principal Commerce 11 Economics 12 English Lit 13 write up 14 Tamil Lit 15 Chemistry 21 Computer Science 22 Mathematics 23 natural philosophy 24 Botany 25 Statistics 26 Choose the watch item from those given to each question. Enter the CODE bit of the item in the order of preference in the boxes provided 01. line of achievement Applied For : BA/BCOM/BSC _______________ 1 2 02. Name (CAPITAL LETTERS) (as in the School certificate) 03. look of redeem 04. Place and District of Birth State: 05. Nationality 06. gravel Tongue 07. Sex: 1.Male 2. Female 08. computer address of the Place of Living: 1. Village 2.Town 3.City 09. Religion: 1.Christian 2. Hindu 3.Muslim 4.Others(Specify) 10. If Christian: 1.Catholic 2. no-Catholic 11. If Catholic Christian: 1.Dalit 2.Non-Dalit 12. Community: 1.SC 2.ST 3.MBC 4.DNC 5.BC 6.

OC ATTESTATION BY PARISH priest (Compulsory for Catholic Students) This is to certify that the applicant______________________________________________________ belongs to my parish and the applicant is a Catholic. The applicant is a Dalit/Non-Dalit. Seal Name and Signature of the Parish Priest 13. Particulars of Parents Father Mother Others Name No. Of Brothers Educational Qualification No. Of Sisters occupancy Order of your Birth Annual Income(Rs/-) Highest Qualification among Brothers & Sisters: 14. Phy sically disabled? 1.Yes 2.No (if yes as! sume the copy of the certificate) 1.Yes 2.No 15. Are you a Son/ girlfriend of an veterinary surgeon? 16. Member of any Service musical arrangement 1.NSS 2.NCC 3.Any Other 17. Co-Curricular Activities 1.Athletics / Games 2.Art 3.Music 4.Literary skills 18. Was your study interrupted? 1.Yes 2.No...If you indigence to get a full essay, order it on our website:
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