GNANAMANI EDUCATIONAL INSTITUTIONS

Online Registration Form for Academic Year 2010-11

Degree	:
Course	:
Name Of The Applicant	:
Father Name	:
Address For Communication	:
Pin Code	:
STD Code	:
State	:
Phone No	:
Mobile No	:
Email	:
Basic Qualification	:
State the Marks	:	Maths: Physics: Chemistry:
Others	:	Vocational Theory: Vocational Practical: Maths:
Exam Reg No.	:
Sex	:	Male Female
Date Of Birth	:	Day: Month: Year:
Nationality	:
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.