ANNEXURE I

AFFIDAVIT BY THE STUDENT

I,
(full name of student with admission / registration / enrolment number), S/o – D/o Mr. / Mrs. /
Ms.

1) having been admitted to THIAGARAJAR COLLEGE OF ENGINEERING have received

a copy of the AICTE/UGC regulations on curbing the menace of Ragging in Higher
Educational Institutions, 2009 (hereinafter called the “Regulations”) carefully read and
fully understood the provisions contained in the said Regulations.
2) I have, in particular, perused clause 3 of the Regulations and am aware as to what
constitutes ragging.
3) I have also, in particular, perused clause 7 and clause 9.1 of the Regulation and am fully
aware of the penal and administrative action that is liable to be taken against me in case
I am found guilty of or abetting ragging, actively or passively, or being part of a
conspiracy to promote ragging.
4) I hereby solemnly aver and undertake that
a) I will not indulge in any behavior or act that may be constituted as ragging under
clause 3 of the Regulations.
b) I will not participate in or abet or propagate through any act of commission or
omission that may be constituted as ragging under clause 3 of the Regulations.
5) I hereby affirm that, if found guilty of ragging, I am liable for punishment according to
clause 9.1 of the Regulations, without prejudice to any other criminal action that may be
taken against me under any penal law or any law for the time being in force.
6) I hereby declare that I have not been expelled or debarred from admission in any
institution in the country on account of being found guilty of, abetting or being part of a
conspiracy to promote, ragging; and further affirm that, in case the declaration is found
to be untrue, I am aware that my admission is liable to be cancelled.

Declared this day of month of year

Signature of Deponent

Name

VERIFICATION

Verified that the contents of this affidavit are true to the best of my knowledge and no part of the
affidavit is false and nothing has been concealed or misstated therein. Verified at (place)
on this (day) of (month) (year)

Signature of deponent

Solemnly affirmed and signed in my presence of this the (day) of month

(year) after reading the contents of this affidavit.

OATH COMMISSIONER
 ANNEXURE II
AFFIDAVIT BY PARENT / GUARDIAN

I, Mr. / Mrs. / Ms.

(full name of parent / guardian) father / mother / guardian of

(full name of student with admission / registration / enrolment numer),

1) having been admitted to THIAGARAJAR COLLEGE OF ENGINEERING have received

a copy of the AICTE/UGC regulations on curbing the menace of Ragging in Higher
Educational Institutions, 2009 (hereinafter called the “Regulations”) carefully read and
fully understood the provisions contained in the said Regulations.
2) I have, in particular, perused clause 3 of the Regulations and am aware as to what
constitutes ragging.
3) I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am
fully aware of the penal and administrative action that is liable to be taken against my
ward in case he/she is found guilty of or abetting ragging, actively or passively, or being
part of a conspiracy to promote ragging.
4) I hereby solemnly aver and undertake that
a) My ward will not indulge in any behavior or act that may be constituted as ragging
under clause 3 of the Regulations.
b) My ward will not participate in or abet or propagate through any act of commission or
omission that may be constituted as ragging under clause 3 of Regulations.
5) I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according
to clause 9.1 of the Regulations, without prejudice to any other criminal action that may
be taken against my ward under any penal law or any law for the time being in force.
6) I hereby declare that my ward has not been expelled or debarred from admission in any
institution in the country on account of being found guilty of, abetting or being part of a
conspiracy to promote, ragging; and further affirm that, in case the declaration is found
to be untrue, I am aware that admission of my ward is liable to be cancelled.

Declared this day of month of year

Signature of Deponent
Name :
Address :

Telephone / Mobile No :

VERIFICATION

Verified that the contents of this affidavit are true to the best of my knowledge and no part of the
affidavit is false and nothing has been concealed or misstated therein. Verified at (place)
on this the (day) of (month) and (year)

Signature of deponent
Solemnly affirmed and signed in my presence of this the (day) of month
(year) after reading the contents of this affidavit.
OATH COMMISSIONER
 ANNEXURE - A
THIAGARAJAR COLLEGE OF ENGINEERING, MADURAI – 625 015.
STUDENT DATA for B.E / B.Tech - FIRST YEAR
2023-2024
Student Roll Number: Student Register Number:
(Filled by Office)

1. HSC/Diploma/Undergraduate Register Number :

Please affix
2. Student Initial :
your Recent
First Name : Passport
Size photo
Last Name :

(As per 12th mark sheet/Diploma certificate)

3. Date of Birth & Age (DD/MM/YYY) :

(As per 12th mark sheet/Diploma certificate)

4. Father’s Name : Mother’s Name :

5. Gender : Male  Female  (√) Marital Status: : Married  Unmarried  (√)

6. Physical Challenged : Yes  No  (√)

7. Nationality: Religion: Community: OC/BC/BCM /MBC/DNC /SC/ST/SCA(√)

8. Caste : Sub Caste :

9. Student's Mobile Number :

10. Communication Address :

Local Address (If same permanent

Details Permanent Address
address  (√))
House No./ Plot No
Address Line 1
Address Line 2
Address Line 3
State
District
Pincode

11. Date of Admission : Student's Type : Days Scholar  TCE Hosteller  Private  (√)

12. Degree admitted : B.E / B.Tech / B.Arch / M.Sc Data Science

13. Branch :

14. Batch : 2023 Semester :

Page 1 of 3
15. Admission Type : Government Aided: Management  General  First Graduate  SC/ST/SCA  (√)
Self Support: Management Merit  Management  General  First Graduate 
First Graduate SC/ST/SCA  SC/ST/SCA  (√)
16. First Graduate : Yes  No (√)

17. Father’s Qualification : Mother’s Qualification :

18. Father’s Occupation & : Mother’s Occupation :

Address

19. Father’s Mobile No: Mother’s Mobile No :

20. Father’s Monthly Income : Mother’s Monthly Income :

21. Parents Monthly Income : Parents Annual Income :

22. Parent E-mail ID :

23. Guardian Details :

Guardian Name: Guardian Mobile No:

House No/ Plot No: Address:

State: District: Pincode: Guardian E-mail ID:

24. Student's E-Mail ID : Birth Place :

25. Mother Tongue : Hobbies:

26. Bank Name : Branch Name:

27. Student's Bank Account No: Student's Passport No:

28. Student's Visa No:

29. Height (Cm) : Weight(Kg): Blood Group:

30. Urban : Yes  No (√)

31. Years of Study in Tamilnadu: Achievements :

32. Identification Marks : 1)

2)

33. Sports Person: Yes  No  (√) If Yes Name

Page 2 of 3
34. Examinations:

Sl.No Details HSC SSLC

1 Year of Exam

2 Exam Roll number

3 School Name

4 School Address

5 School Medium

6 Board of Examination State board/CBSE/ICSE State board/CBSE/ICSE

7 Marks obtained

8 Maximum marks

9 Grade

10 Percentage/Percentile

11 Number of Attempts

12 School type Government/Private Government/Private

35. HSC Cut-off marks :

36. HSC Over all Marks & Percentage :

a) Tamil: b) English: c) Physics: d) Chemistry:

e) Mathematics: f) Biology: g) Computer Science:

37. NATA Score for B.Arch students :

38. Year of Exam: State Rank:
39. Percentage: Exam Roll No:

40. Percentile: Quota: Entrance Exam Score:

Declaration:

I hereby declare that all the information given above are true and correct to the best of my knowledge
and belief.
Date:
Place:

Signature of the Student Signature of the Parent

Page 3 of 3
 ANNEXURE - B

THIAGARAJAR COLLEGE OF ENGINEERING, MADURAI - 625015

_______________________________________________________________

PHYSICAL FITNESS CERTIFICATE

I do hereby certify that I have examined Thiru / Selvi

______________________________ a candidate for admission to the
_____________________________________________________ Programme and confirm that he /
she does not has any disease and constitutional defect or bodily infirmity except (*)
__________________________________.

(*) I do not consider this as a disqualification for undergoing the courses in Engineering.

His / Her age according to his / her own statement is ___________________ years and by appearance
about _________________ years. He/She has marks of small pox / vaccination.

Personal marks of identification

1.
2.

Blood Group & Rh Type :

General Examination: Height _________cms; Weight______kgs.

Pulse ________ / Min; B.P__________mm Hg
Resp. Rate _______/ Min; Insp______cms; Exp ______cms

Date : Signature of Medical Officer with Seal

Place :

(*) Any defect or other disabilities when present should be noted in detail.
 ANNEXURE - C

JOINT DECLARATION BY THE CANDIDATE AND PARENT / GUARDIAN

(This should not be enclosed along with the application.
It should be submitted at the time of admission)

I hereby solemnly and sincerely affirm:

1. That the statements made and information furnished in my son's / daughter's / ward's application and
also in all the enclosures there to submitted by him / her are true. Should it however, be found that any
information furnished there in is untrue in material particulars, I realise that I am liable to criminal
prosecution and I also agree to the forfeiture of the seat in the institution.

2. That my son / daughter /ward would confirm strictly to all the rules and regulations in force now or
which may be introduced in the institution hereafter and that I realise that breach of discipline and rules on
my son's/daughter's/ ward's part would entail summarily forfeiture of his /her seat in the institution.

3. That I am aware that if my son / daughter / ward does not put in a minimum percentage of attendance
prescribed by the university during the year in theory, drawing and practical class separately, my
son/daughter/ward will not be permitted for the University Examination.

4. That I am aware that the curriculum for the various courses is not rigid and that my son/daughter/ ward will
follow the syllabi for the various courses in force at the time of his/her admission and that any revision or
modification made in the syllabi during the course of his / her study in the institution will be binding on
him / her.

5. That I am aware that if my son / daughter / ward does not get a minimum of 50 percent of marks in the
day to day valuation of his/her work and progress he/she will not be permitted for the University
Examinations.

6. That in case of my son's / daughter's / ward's progress in studies is uniformly poor in the institution his/ her
studies are liable to be terminated by the issue of Transfer Certificate.

7. That in case my son / daughter / ward becomes a scholarship holder or enjoy educational concessions
like half-fee or full-fee etc., and does not show special progress, the scholarships or educational
concessions are liable to be cancelled and that if my son's / daughter's/ ward's conduct and character
are not good these will be cancelled.

8. That my son / daughter / ward is aware that breach of discipline and rules or bad conduct in the N.C.C.
or extra-curricular activities will also entail summarily forfeiture of seat in the institution, in addition to such
other proceedings that may be taken against him / her.

9. That I am aware that if my son / daughter / ward is admitted in the hostel he / she will strictly abide by the
rules and regulations in force in the hostel and that any breach of discipline or rules or any unruly conduct
or undesirable activities will be summarily dealt with by the forfeiture of seat both in the hostel and the
institution in addition to such other proceedings that may be taken against him / her.

10. That I am fully aware, as per the directions of the Hon’ble Supreme Court of India and Tamil Nadu
Prohibition of Ragging Act 1997, Ragging is an offence, as is banned in the Institution and anyone indulging
in ragging is liable to be punished such as expulsion from the Institution and / or rigorous imprisonment upto
3 years, and / or fine upto Rs.25000/-

11. That my son / daughter /ward will strictly follow the Standard Operating Procedure (SOP) imposed
by the Government both in the College as well as in the hostel due to the prevailing COVID 19
situations.

Place:

Date:

Signature of the Candidate Signature of the Parent / Guardian.

 ANNEXURE - D

FIRST GRADUATE CONCESSION-JOINT DECLARATION FORM

I hereby declare the following details of my family members and their education qualifications
to avail the tuition fee waiver for my studies in professional courses under the scheme of
waiver of tuition fees to the students from the family where there are no graduates.
Sl. Name Relationship Father / Age Educational Whether
No Mother / Brother / Qualification Degree
Sister / Grand Father holder
/ Grand Mother
(1) (2) (3) (4) (5) (6)
Applicant

Father

Mother

Father’s Father

Father’s Mother

Mother’s Father

Mother’s Mother

Brother / Sister

Brother / Sister

Brother / Sister

Brother / Sister

Brother / Sister

I hereby solemnly and sincerely affirm that I am the first person from my family to claim the
waiver of Tuition Fee for entire Professional Course of study and there is no graduate in my family
so far. The particulars furnished above are true. Should it, however, be found that any information
furnished therein is false in material particulars on verification at a large stage, I am liable for
criminal prosecution and I also agree to return the amount equal to three times the tuition fee
waiver availed by me.

Date :
Place :
SIGNATURE OF THE CANDIDATE

I solemnly and sincerely affirm that I am fully aware of the above declaration and the particulars
furnished in the declaration are correct. I am liable for the criminal action / recovery of amount
equal to three times of the fees waived, for incorrect particulars furnished.

Date:
Place:
SIGNATURE OF THE PARENT / GUARDIAN