KHADIR MOHIDEEN COLLEGE

(M.K.N. Madharasa Trust - Waqf)
Affiliated to Bharathidasan University
Adirampattinam - 614 701, Thanjavur District, Tamil Nadu.

KHADIR MOHIDEEN COLLEGE

UNDERGRADUATE ADMISSION FORM

Important Instructions

Please read the following instructions carefully before filling out the admission form:

All fields marked with * are mandatory
Have all required documents ready before starting the application
Upload clear scanned copies of documents in JPG/PNG format (Max 50KB each)
Student photo should be passport-size with white background
Double-check all information before submission
Incomplete forms will not be processed
You cannot edit the form after submission

Required Documents: 10th & 12th Mark Sheets, Transfer Certificate, Community Certificate, Aadhar Card, Passport Photo

Personal Details

Name of the Student *

Email *

Gender *

Phone Number *

Date of Birth *

Date of Application *

Blood Group *

Nationality *

Religion *

Caste *

Previous Promotion Status *

Medium of Study *

Mother Tongue *

Student EMIS Number *

Student Aadhar Number *

Photo Upload

Student's Photo (Max: 50KB, JPG/PNG) *

Choose File

No file chosen

Parent's/Guardian's Photo (Max: 50KB, JPG/PNG) *

Choose File

No file chosen

Address Details

Street Address *

City *

Post/Zip Code *

State *

Country *

Full Address *

Parent's Details

Father's Name *

Father's Occupation *

Father's Mobile Number *

Mother's Name *

Mother's Occupation *

Mother's Mobile Number *

Annual Income of Parents *

Course Details

Course *

Bank Account Details

Bank Name *

IFSC Code *

Account Number *

Account Holder Name *

Branch Name *

Additional Information

Distinction in Sports/NCC/NSS? *

Yes

No

Distinction Details *

Differently-abled student? *

Yes

No

Disability Details * Attach Disability Certificate *

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No file chosen

HSE Education Details

Name & District of School last studied *

12th Std Register No. *

10th Std Register No. *

10th Std Marks (Out of 500) *

12th Std Marks (Out of 600) *

12th Std Group *

HSE Marks Details

Subject Name	Marks (out of 100)	Attempts	Passed Date

Total Marks (out of 600):

Percentage Obtained: