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Name of the College*

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Marks Obtained - Higher Secondary

Subject	Maximum Marks	Marks Secured	Marks Secured in +2

PHYSICS
CHEMISTRY
BIOLOGY
ENGLISH
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I, .................................... do hereby declare that the particulars given in the application are true to the best of my knowledge and belief. If any of the particulars given by me in this application is proved fraudulent at any later stage of admission, I shall be liable for disciplinary action and my admission shall become null and void. I shall produce the originals of the certificates at the time of interview.I carefully read the prospectus thoroughly and I am ready to abide the terms and conditions mentioned in the Prospectus.

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Panayoor, Vaniyamkulam,Ottapalam,Palakkad District-679522

Marks Obtained - Higher Secondary

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