EXTRA CURRICULAR ACTIVITIES

Technical Seminar Publication Mini project Sports Cultural Association post held Any other :

DEPARTMENT OF ELECTRONICS AND COMMUNICATION ENGINEERING ANNA UNIVERSITY, CHENNAI- 600 025

STUDENT RECORD
COURSE :
CATERGORY: Gate Non-Gate Sponsor

: Admitted Year : : : : : : Reg. No Name : : Affix your passport photo here

Male/Female : Date of Birth Blood Group Community : : : OC BC ADDRESS MBC SC ST

ANY OTHER INFORMATION

I Semester II Semester III Semester IV Semester PASSED OUT YEAR :

Permanent Address . . Phone No. : Email :

Local Guardian Address . . Phone No. : Email :

PARENT DETAILS : : STAY AT : i) Hostel : I Year Address . . Phone No. : Email : II Year Address . . Phone No. : Email : ii) House iii) Local Guardian iv) Others Name Occupation Contact number(mobile number)

EDUCATIONAL DETAILS NAME & SIGNATURE OF Faculty Mentor PROFESSOR & HEAD Department of ECE Name of the board/ university Name of the Institution Year of Passing Percentage of Marks