Admission date : ..............................

Application No.

Surya School Of Architecture

surya group of institutions

GST Road,Vikravandi, Villupuram(Dt.),

Villupuram(Dt.)-605652
1.Personal details:
Name
(in CAPITAL letters with initials) :
Name of the Father

Name of the Mother

Gender ( )

Space for affixing

the
Passport size
Photograph
duly attested by

Male Female

Father / Guardian

Name:
Occupation:

Age & Date of Birth

Age:

Date of Birth:

Caste*/Community/Religion/Nationality

Caste:

Community:

Religion:

Nationality:

*copy of permanent community certificate

card must be enclosed.

Place of Birth (enclose photo copy)

Town :

District:

State:

Communication Address

Phone with STD code

Mobile
e-mail

2. Educational Qualification:
a.School / Polytechnic
Examination Passed

Name of the School / Polytechnic College

and place

Branch

X Std
+2
Polytechnic

Medium of
Study

Year of
Passing

% of Marks /
CGPA

Remarks (if any)

3. Whether Polytechnic Certificates is enclosed

4. Enclosed Polytechnic Certificates

Yes / No

Consolidated Mark Sheet

Provisional certificate
Degree Certificate

5.Category of the Applicant

(Please mark over the appropriate box)

Gov Quota Man Quota

6.Enclosed Students Original Certificates GOVERNMENT QUOTA

Tick()

Sl.No
1

Original Certificates GOVERNMENT QUOTA

Government Quota (GQ)

NATA Mark sheet

Community Certificate (Permanent Card)

Transfer Certificate (TC)

+2 Mark Sheet (including arrear mark sheet if any)

Diploma Mark sheet and Provisional Certificate

First Graduation Tahsildar Certificate

First Graduation - Joint Declaration signed by Parent and Student

PH (Physically Handicapped) - Medical Board Certificate

Remarks

7. Enclosed Students Original Certificates MANAGEMENT QUOTA

Sl.No
1
2
3
4
5
6
7

Students Original Certificates MANAGEMENT QUOTA

NATA mark sheet
Community Certificate (Permanent Card)
Transfer Certificate (TC)
+2 Mark Sheet (including arrear mark sheet if any)
Diploma Mark sheet and Provisional Certificate
PEC (Provisional Eligibility Certificate) for NRI / Foreign Nationals
Equivalency Certificate (if required)

8. Whether all Original Certificates copy is enclosed

Yes / No

Tick()

Remarks

DECLARATION BY THE CANDIDATE

I, _________________________, hereby declare that all the particulars stated in this application and
enclosures are true to the best of my knowledge and belief. I have read the Information Brochure and I shall
abide by the terms and conditions therein. I am aware that my admission will be provisional and in the event
of my being found ineligible at the time of reporting, my admission will be denied.

Place:
Date:

Signature of the Candidate

FOR OFFICE USE ONLY

Application Received Date :
Receipt No
:
Received By

Checked By

_______________________

_________________________

(Name & Signature)

(Name & Signature)

Recommendation of HOD

Joint Declaration by the Parent or Guardian and the Applicant

I hereby solemnly and sincerely affirm :
1.
2.

I have gone through the Prospectus and understood the Rules and Regulations framed by the Institution and the fees as prescribed.
That the statements made and information furnished in my son's / daughter's / ward's application as also in all the enclosures there to
be submitted by him / her are true. Should it however be found that any information furnished therein is untrue in material particulars,
I realise that I am liable to criminal prosecution and I also agree to the forfeiture of his/her seat in the institution.
3. That my son/daughter/ward would conform strictly to all the rules and regulations in force now or which may be introduced in the
institution hereafter and that I realise that breach of discipline and rules on my son's/daughter's/ward's part would entail summary
forfeiture of his/her seat in the institution.
4. That I am aware that the curriculum for the various courses is not rigid and that my son/daughter/ward will follow the syllabi for the
various courses in force at the time of his/her admission that any revision or modification made in the syllabi during the course of
his/her study in the institution will be binding on him/her.
5. That in case of my son's/daughter's/ward's progress in studies is uniformly poor in the institution, his/her studies are liable to be
terminated by the issue of Transfer Certificate.
6. That in case my son/daughter/ward becomes a scholarship holder and does not show special progress, the scholarship is liable to be
cancelled and that if my son's/daughter's/ward's conduct and character are not good, it will be cancelled summarily.
7. As per the University regulation I am aware that if my son/daughter/ward does not put in a minimum of 75 percent attendance during
the semester, my son/daughter/ward will not be permitted to write the University Examination.
8. That my son/daughter/ward is aware that breach of discipline and rules or bad conduct in academic, co-curricular and extra-curricular
activities will also entail summary forfeiture of seat in the institution, in addition to such other proceedings that may be taken against
him/her.
9. That I am aware that if my son/daughter/ward is admitted into the hostel he/she will strictly abide by the rules and regulations in
enforce in the hostel and that any breach of discipline or rules or any unruly conduct or undesirable activities will be summarily dealt
with by forfeiture of seat both in the hostel and the institution in addition to such other proceedings that may be taken against him/her.
10. That in case the qualifications possessed by my son/daughter/ward is not recognised by the University, the admission to the M.E.
degree course is liable for cancellation.
11. I understand that the institute will not permit leaving the Institute / transfer in the middle.
12. I agree to abide by the rules and regulations of the College and Hostel.

Accorded and Signed below :

I understand that Admission will be made on the basis of the procedures stipulated by the Govt.

Name :

Signature of the Parent/Guardian

I have also read, understood and give my

consent for the above declaration.
Place :
Date :

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Name :

Signature of the Student