UMIS REGISTRATION FORM
COLLEGE INFORMATION (FOR OFFICE USE ONLY)
1 NAME OF THE COLLEGE :
2 COLLEGE CODE (UMIS) :
3 COLLEGE DISTRICT :
4 COLLEGE REGION :
STUDENT GENERAL INFORMATION
5 STUDENT EMIS ID :
6 IF THERE IS NO EMIS ID SPECIFY REASON : (OTHER STATE/ STUDIED BEFORE 2018 / ISCE - OPEN
SCHOOL OR TUTORIAL)
7 SALUTATION (SELVAN/SELVI/THIRU/TMT) :
8 Student Name (As on Certificate)* :
9 Student Name (As on Aadhaar)* :
10 Student Date of Birth * (DD/MM/YYYY) :
11 Gender * :
12 Blood Group * :
13 Nationality * :
14 Religion * :
15 Community * :
16 Caste * :
17 Online Community Certificate Number * :
18 Aadhaar Number * :
19 Is the student the first graduate in the
family?* (Yes/No) :
a) If Yes, First Graduate Certificate Number :
20 Did you come under any special admission
Quota?* (Yes/No) :
a) If Yes, Category : Differently Abled / Sports/Ex-Servicemen/Andamaan-
Nicobar/NCC/Defence
21 Did you belong to differently abled category?*
(Yes/No) :
a) If Yes : UDID (Unique Disability ID Number) :
b) Nature(Type) of Disability :
1.Blindness 12.Muscular Dystrophy
2.Low-Vision 13.Chronic Neurological Conditions
3.Leprosy Cured Persons 14.Specific Learning Disabilities
4.Hearing Impairment (deaf and hard of 15.Multiple Sclerosis
hearing)
5.Locomotor Disability 16.Speech and Language Disability
6.Acid Attack Victim 17.Thalassemia
7.Dwarfism 18.Hemophillia
8.Intellectual Disability 19.Sickle Cell Disease
9.Mental Illness 20.Multiple Disabilities Including Deaf Blindness
10.Autism Spectrum Disorder 21.Parkinson's Disease
11.Cerebral Palsy
c) The Extent of (%) of Disablity :
Contact Information
22 Mobile Number * :
23 Email Id * :
24 Country * :
25 State / Union Territory :
26 Location Type : Rural/Urban
27 District :
28 Taluk :
29 Village :
30 Block * :
31 Village Panchayat :
32 Pincode * :
33 Postal Address * :
Communication Address:
34 Country * :
35 State / Union Territory * :
36 Location Type * :
37 District * :
38 Taluk * :
39 Village * :
40 Block * :
41 Village Panchayat * :
42 Pincode * :
43 Postal Address * :
Family Information
44 Father's Name :
45 Father's Occupation / Sector : (Daily Wage/Govt/N.A/Private/Self-
Employed/Unemployed)
46 Mother's Name :
47 Mother's Occupation / Sector : (Daily Wage/Govt/N.A/Private/Self-
Employed/Unemployed)
48 Guardian's / Spouse's Name :
49 Is Orphan Category * :
50 Annual Family Income (in Rs) * :
51 Income Certificate Number * :
52 Parent / spouse / Guardian Mobile Number* :
Bank Information
Aadhaar Seeding Status
53 Aadhaar Number * :
54 Mobile Number * :
55 Bank Name * :
56 Status * : (Active/Not Active)
57 Message * : (Your Bank Account - Aadhaar Seeding has been done)
Account Activites Status
58 Account Number * :
59 IFSC Code * :
60 Bank Name * :
61 Bank Branch * :
62 City * :
63 Account Type * :
Current Academic
Information
64 Academic Year of Joining * : 2025-2026
65 Stream Type * : ARTS & SCIENCE
66 Course Type * : UG/PG/PHD
67 Course * : BSC/BCOM/BBA/BA/MA/MCOM/MSC
68 Branch / Specialization * :
69 Medium of Instruction * : TAMIL/ENGLISH
70 Mode of Study * : REGULAR
71 Date of Admission * :
72 Type of Admission * :
73 Counselling / Admission Number* :
74 Registration / Roll Number* :
75 Has the student joined as lateral entry ?*
(YES/NO) :
76 Hosteller *(YES/NO) :
77 Current status of the student ?* :
78 Year of Course Completed * :
79 Year of Study * :
80 School of Study Information(From 6th to 12th Std)
Class District School Name as per Type of School
Records (Govt/Aided/UnAided)
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