TAMIL SPEAKING UNION
Email: tamilspkunion@yahoo.co.uk; Tel: 465 6714
Courses in Spoken Tamil - 2014
Application Form
Course applied for:
Centre applied for:
(tick appropriate)
(1) Basic Level
Name and Address of Centre: ___________________
(2) Lower Intermediate Level
___________________________________________
(3) Upper Intermediate Level
Day
: ____________________________________
(4) Advanced Level 1
Time
: ____________________________________
Surname of Applicant: _______________________________________________________
Other names: _________________________ Maiden Name: _________________________
Marital Status: _________________ Age: ______________ Sex: ______________________
Home Address: _____________________________________________________________
Email: ___________________ Tel No. Res: ______________ Mob: __________________
Occupation: ________________________________________________________________
Place of Work: ______________________________________________________________
Name and Address of Guardian (if under 18): _____________________________________
__________________________________________________________________________
Academic Qualifications:
CPE
Subject
SC OR GCE O LEVEL
Grades Subject
HSC OR GCE A LEVEL
Grades Subject
Grades
Principal Level
Subsidiary Level
Other Qualifications:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
I certify that the above information is correct
Date: _________________________ Signature of Applicant: _____________________
FOR OFFICE USE:
To be filled by Coordinator:
Appl. /Reg. fee
Tuition fee*
Certificate fee
Rs 300
Rs 300/Rs 500
Rs 200
Paid / Not Paid
Receipt No
____________
__________
____________
__________
____________
__________
Donation (if any)
____________
Total:
____________
Name of Coordinator / Authorized officer: ________________ Signature: _______________
* Unemployed – Rs 300
Employed – Rs 500