ANNAMALAI UNIVERSITY

FORM OF APPLICATION FOR REGISTRATION

DEGREE/DIPLOMA/CERTIFICATE/FOUNDATION/GRADE EXAMINATIONS MAY 2017
(FOR STUDENTS OF DISTANCE EDUCATION)
[ALL ENTRIES SHOULD BE IN CAPITAL LETTERS]
_____________________________________________________________________________________________________________________

I. COURSE : Affix recent

passport size
photo attested
II. COURSE CODE :
by self

III. ENROLMENT NUMBER :

1.EXAMINATION CENTRE CODE: CENTRE NAME:

(REFER TO THE CENTRE CODE LIST ATTACHED)

2.CANDIDATE NAME:

3.ADDRESS:

PIN:

4. SUBJECT CODES OF (THEORY ,PRACTIAL & PROJECT) PAPERS FOR WHICH APPEARING NOW:

I II III IV V VI VII VIII

I-SEM/YEAR
IX X XI XII XIII XIV XV XVI

II-SEM/YEAR

III-SEM/YEAR

IV-SEMESTER

V-SEMESTER

VI-SEMESTER

5. REG.NO. OF LAST APPEARANCE IF ANY:

6. EXAMINATION FEES PAID BANK DETAILS: (ENCLOSE ORGINAL D.D. / CHALLAN)

(A) DD DETAILS:

NAME OF BANK : DD NO:

BRANCH CODE : AMOUNT:

D.D. DATE : _ / _ / 20_

(B) CASH CHALLAN :

PAID AT CASH COUNTER / IB: CHALLAN NO:

DATE : _ / _ / 20_ AMOUNT:

(C) SWIPING PAYMENT TRANSACTION ID: AMOUNT:

DATE : _ / _ / 20_
7. I HAVE REMITTED THE TUTION FEES UP-TO-DATE. YES NO
8. I HAVE ATTENDED THE COMPULSORY PERSONAL CONTACT PROGRAMME. YES NO

DATE : SIGNATURE OF THE CANDIDATE

NOTE: PLEASE RETAIN A COPY OF THE APPLICATION AND THE DD/CHALLAN FOR FURTHER CORRESPONDENCE
HALL TICKET CAN BE DOWNLOADED FROM THE WEBSITE FROM 09.05.2017 ONWARDS
(P.T.O.)
 EXAMINATION CENTRE NAME AND CODE MAY-2017
:
CENTRE CENTRE CENTRE
CODE CENTRE NAME CODE CENTRE NAME CODE CENTRE NAME
TAMILNADU TAMILNADU KARNATAKA
001 ANNAMALAINAGAR 033 PUDUKKOTTAI 075 BENGALURU
002 ARAKKONAM 149 RAJAPALAYAM 077 MYSORE
003 ARIYALUR 034 RAMANATHAPURAM 076 MANGALORE
137 ATTUR 138 RASIPURAM 142 BELLARY
005 CHENGALPATTU 035 SALEM KERALA
006 CHENNAI 036 SANKARANKOIL 078 ALLEPPY
007 COIMBATORE 037 SIVAGANGAI 079 CALICUT
143 CUDDALORE 038 SIVAKASI 080 ERNAKULAM
008 DHARAPURAM 141 TENKASI 081 KANNUR
009 DHARMAPURI 039 THANJAVUR 082 KASARCODE
010 DINDIGUL 040 THENI 083 KOTTAYAM
011 ERODE 041 TIRUCHIRAPPALLI 084 NILESHWAR
012 GINGEE 042 TIRUNELVELI 085 THIRUVANANTHAPURAM
013 GOBICHETTIPALAYAM 043 TIRUPATTUR (Vellore Dt.) 086 TRICHUR
014 HOSUR 044 THIRUVALLUR 087 QUILON
015 KALLAKURICHI 045 THIRUVANNAMALAI MAHARASHTRA
016 KANCHIPURAM 046 THIRUVARUR 092 MUMBAI
017 KARAIKUDI 139 THURAIYUR 094 PUNE
018 KARUR 047 TINDIVANAM MEGHALAYA
148 KOVILPATTI 048 TIRUCHENDUR 095 SHILLONG
019 KRISHNAGIRI 049 TIRUPPUR PUDUCHERRY
020 KUMBAKONAM 050 TITTAKUDI 096 KARAIKKAL
021 MADURAI 051 TUTICORIN 097 PUDUCHERRY
022 MARTHANDAM 053 ULUNDURPET RAJASTHAN
023 MAYILADUTHURAI 054 VEDARANYAM 105 JAIPUR
024 METTUPALAYAM 055 VELLORE WEST BENGAL
025 METTUR 056 VILLUPURAM 113 KOLKATA
027 NAGERCOIL 057 VIRUDHUNAGAR UNION TERRITORIES
028 NAMAKKAL ANDHRA PRADESH 114 CHANDIGARH
029 OOTY 058 HYDERABAD 115 NEW DELHI
144 PANRUTI 059 TIRUPATHI 116 PORT-BLAIR
031 PERAMBALUR 060 VIJAYAWADA
032 POLLACHI 061 VISHAKAPATNAM

Note:

I. Care fully write the exam center code Neatly & Legibly
II. Based on the code only allotment made
III. Code once applied will not be changed under any circumstances
IV. Based on vacancy exist, the exam center will be allotted.