SASTRA DEEMED UNIVERSITY
Tirumalaisamudram 613401
Ph - 4362350011
admissions@[Link]
Website - [Link]
Applicant Details
Applicant Photo :
Name of the Applicant :
(As Per Certificate)
Date of Birth :
Gender :
Blood Group :
Mobile Number :
Personal Email Id :
Aadhaar Card Number :
Nationality/Country :
Religion :
Caste :
Community :
Persons with disability :
(PWD)
Single Parent :
Father's Details
Father's Name :
Mobile Number :
Email :
Father's Organization :
Type
Name of Organization :
Designation :
Annual Income :
Government :
Organization Type
Private Organization :
Type
Self Employee Type :
Mother's Details
Mother's Name :
Mobile Number :
Email Id :
Mother's Organization :
Type
Name of Organization :
Designation :
Annual Income :
Working :
Government Type :
Private Organization :
Type
Self Employee Type :
Guardian's Details
Name :
Mobile Number :
Email Id :
Name of Organization :
Designation :
Annual Income :
Relationship With :
Applicant
Guardian Permanent Address
House Number :
Address Line 1 :
Address Line 2 :
Pincode :
Country :
State :
District :
City :
Permanent Address
House Number :
Address Line 1 :
Address Line 2 :
Pincode :
Country :
State :
District :
City :
Mailing Address
House Number :
Address Line 1 :
Address Line 2 :
Pincode :
District :
City :
Choice of Branch
Degree :
Program :
Education Details
X Education Details Details
Name of School :
Board :
Year of Passing :
Total Marks :
Obtained
Max Marks :
Overall Percentage :
Obtained Grade :
Max Grade :
Obtained CGPA :
Max CGPA :
School Country :
School State :
School City :
XII Education Details Details
Name of School :
Board :
Year of Passing :
Stream :
Total Marks :
Obtained
Max Marks :
Overall Percentage :
Obtained CGPA :
Max CGPA :
School Country :
School State :
School District :
School City :
Applicant Signature Signature of the Parent/Guardian
Date: