Thiruvalluvar University - Serkadu, Vellore, Tamil Nadu, India

Name of the Student (English)

Name of the Student (Tamil)

Department

Registration Number

Degree

Academic Year

Father's / Mother's Name (English)

Father's / Mother's Name (Tamil)

Mobile Number

Nationality

Religion

Date of Birth

Date of Admission

Reason for Leaving the University

Sr. No.	Department / Section	Dues (If Any)	Signature with Seal
13	Central Library
14	Department of Physical Education
15	NSS
16	Department Laboratory
17	Hostel Warden
18	Guide / Supervisor
19	Scholarship Section
20	Admission Section
21	Head of the Department

Student’s Conduct & Character