College of Education

B.Ed M.Ed

APPLICATION FOR B.Ed ADMISSION

College Code & Name:

Name of the Candidate (as per SSLC Certificate) in Block Letters (initial at the last column after a space)

In English

Student Image

Gender

DATE OF BIRTH

Aadhaar Number

Specify the Community (OC/BC/MBC/DNC/SC/SC(A)/ST)

Specify PC for Physically Challenged VC for Visually Challenged DW for Destitute Women) (Affiliated Proof)

Name of the Father

Name of the Mother

Name of the Guardian

Father Occupation

Annual Income

Address for Communication

Pincode

Mobile No.

Email ID

Medium of Instruction (in B.Ed., Degree Programme) (Select one)

B.Ed., Degree Programme - Pedagogical Subject

Name of the Pedagogical Subject Chosen in B.Ed.,

Details Examination Passed Under 10+2+3 or 11+1+3

S. No	Course	Year of Study
		From	To
1.	SSLC
2.	HSC
3.	UG
4.	PG

Details of UG Degree Marks (Part III & Part IV)

Subject	Major & Allied Subjects	Total Marks Obtained	Maximum Marks (Total)	% of Marks
Part III
Part IV

Details of PG Degree Marks (M.Com / M.A., Eco)

Course	Major & Allied Subjects	Total Marks Obtained	Maximum Marks (Total)	% of Marks

Declaration

I hereby declare that the above mentioned particulars are true and correct to the best of my Knowledge and belief. In case of any default detected later, I understand that my candidature will be forfeited.

Place

Signature of the Candidate

Date

Signature of the Parent / Guardian

Application

APPLICATION FOR B.Ed ADMISSION

Details Examination Passed Under 10+2+3 or 11+1+3

Details of UG Degree Marks (Part III & Part IV)

Details of PG Degree Marks (M.Com / M.A., Eco)

Declaration

Thiruvalluvar Group of Institutions