Merit College Of Education

Name of the Candidate * :

Date of Birth * :

Age * :

Gender * : Male Female

Upload Photo * :

Religion * : Hindu Muslim Christian Others

Caste * :

Community * : SC ST BC MBC OC DNC Others

Aadhar Number * :

Father's Name / Guardian Name * :

Father's Occupation * :

Mother's Name * :

Mother's Occupation :

Annual Income of Parents * :

Address for Communication * :

City * :

District * :

Pincode * :

Telephone Number / Mobile Number * :

Name of Brother/Sister if any studying in this college :

Permanent Address * :

B.Ed. Degree programme - Pedagogical subject * :

Differently Abled * : Yes No

Destitute Widow Candidates * : Yes No

Alternative Mobile No. :

E-mail * :

Medium of Study * : Tamil English Other

Details of Qualifying Examination Passed * :

	SSLC	HSC	UG Degree
1. Year of Passing
2. Register Number
3. Total Mark Obtained
4. Total Mark Obtained out-off
5. Total Mark Obtained in Percentage

Educational Qualification * :

Marital Status * : Married UnMarried

Referred by :

Details of UG degree passed by the candidate :

Name of the UG Degree	Major Subject	Allied Subject	% of marks(Major & Allied)	University Name	Month & Year of passing

Details of PG degree passed by the candidate :

Name of the PG Degree	Major Subject	% of Marks	University Name	Month & Year of passing

Declaration * : I hereby declare that the particulars are true to the best of my knowledge.

Signature of Parent / Guardian * :

Signature of Applicant * :

Place * :

Date * :