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Cost of Application :
No.12, Vembuliamman Koil Street, West K.K. Nagar,Date : Chennai 600 078
Institute of Distance Education Diploma / Under Graduate Degree Examinations Dec 2013 Application Form
: .. : .. : ... Affix Photograph 5cm x 5cm Duly signed By the candidate
Register Number 1. EXAMINATION CENTRE 2. Name IN ENGLISH Name IN TAMIL (as per +2 or other qualifying exam)
SEX :
Male
Female
3. Date of Birth
(Christian Era ) (as per +2 or other Qualifying exam)
: DATE
MONTH
YEAR
: : ... ...
5. Community OC
: SC
ST
BC
MBC
DC
YEAR
Subject Code
FIRST YEAR
SECOND YEAR
THIRD YEAR
Month & year May / Dec (to be filled in by the candidate) Examination fees Cost of Application form Provisional Certificate Fee Convocation Fee Penalty Fee Total
: : : : : :
(Final year students are to pay the towards Convocation, issue of provisional certificate)
Name of the Bank : D.D. No & Date D.D. Amount Rs. : : :
Signature of Student
DETAILS OF FEES UG Courses: Theory Practical Cost of Application Mark Statement Rs.200/ Per Paper Rs.100/ Per Paper Rs.50/Rs.200/-
PG Courses: Theory Practical Cost of Application Mark Statement Diploma Courses: Theory Practical Cost of Application Mark Statement Rs.100/ Per Paper Rs.100/ Per Paper Rs.25/Rs.100/Rs.400/ Per Paper Rs.500/ Per Paper Rs.100/Rs.200/-
PG Diploma Courses: Theory Practical Cost of Application Mark Statement Rs.300/ Per Paper Rs.250/ Per Paper Rs.50/Rs.200/-