Online Registration
Application For:



Degree
Degree
Category of Admission :

Personal Details



Full Name
Name of the
Parent/Gaurdian
Parents
Occupation
Date Of Birth :
Sex :
Nationality :

Permanent Communication Details



Address :
City :
State :
Country :
Phone :
E - :

Local Gaurdian Details



Address :
City :
State :
Country :
Phone :
E - :

Passport Details



Note: For Nepal and Bhutan students they can enter either Citizenship Card No or Passport Details. Others must enter their Passport Details.


Citizenship
Card No :
OR
Passport No :
Date of Issue :
Date of Expiry :
Place of Issue :

Visa Details



Visa No :
Date of Issue :
Date of Expiry :
Place of Issue :

Qualifying Examination Details



Exam Passed/Appeared :
Name of
Institution :
Board of Examination :
Year of Passing :
% of Marks
Scored/
Anticipated :
% Marks Scored in Physics :
% Marks Scored in Chemistry :
% Marks Scored in Mathematics :
Medium of Instruction :
Others

Other Details



Mother Tongue :
Vaccination Details :
Whether Hostel Accommodation required :
Your Message




DECLARATION BY THE APPLICANT

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 understand that my admission will be provisional and in the event of my being found ineligible at the time of admission, I will be denied admission and, if already admitted my admission will be cancelled. I also understand that in all matters concerning admission, the decision of the Anna University is final and I shall abide by it.


Place
Date



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