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    Application Form For Identity Card PDF

    Uploaded by

    Sankar Venkatesh
    This document contains an application form for a Tamil Nadu Dental Council identity card. The form requests information such as the applicant's name, address, qualifications, registration number, date of birth, contact details, and payment details. Instructions are provided for completing the form correctly, including enclosing three recent passport photos and payment of Rs. 150 by demand draft. Supporting documents like registration and birth certificates must also be submitted.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Application Form For Identity Card PDF

    Uploaded by

    Sankar Venkatesh
    4K views2 pages
    This document contains an application form for a Tamil Nadu Dental Council identity card. The form requests information such as the applicant's name, address, qualifications, registration number, date of birth, contact details, and payment details. Instructions are provided for completing the form correctly, including enclosing three recent passport photos and payment of Rs. 150 by demand draft. Supporting documents like registration and birth certificates must also be submitted.

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    Application form for Identity Card.pdf

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    This document contains an application form for a Tamil Nadu Dental Council identity card. The form requests information such as the applicant's name, address, qualifications, registration number, date of birth, contact details, and payment details. Instructions are provided for completing the form correctly, including enclosing three recent passport photos and payment of Rs. 150 by demand draft. Supporting documents like registration and birth certificates must also be submitted.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    4K views2 pages

    Application Form For Identity Card PDF

    Uploaded by

    Sankar Venkatesh
    This document contains an application form for a Tamil Nadu Dental Council identity card. The form requests information such as the applicant's name, address, qualifications, registration number, date of birth, contact details, and payment details. Instructions are provided for completing the form correctly, including enclosing three recent passport photos and payment of Rs. 150 by demand draft. Supporting documents like registration and birth certificates must also be submitted.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    TAMIL NADU DENTAL COUNCIL

    CHENNAI – INDIA

    APPLICATION FOR IDENTITY CARD

    To
    Tamil Nadu Dental Council Affix your
    Arihant Majestic Towers recent passport
    Flat No.5-0-3, No.216, J.N. Salai, size photo
    Koyambedu,
    Chennai – 600 107.

    1. Name of the Applicant :


    2. Father’s Name :
    3. Qualification :
    4. TNDC Regn.No. :
    5. BDS Date of Regn. :
    6. Permanent Address with :
    Pincode & District name
    (Tamil Nadu Address only)*

    7. Date of Birth :
    (Evidence should be attached)
    8. Phone Number :
    (Land line with STD Code)
    9. Mobile Number : 1. 2.
    10.Email Id (Fill in block letters) * :
    11.DD Details
    Bank Name & Branch:
    DD No. & Date :

    Total Fees No. of. Id Card Signature:


    Date:
    -2-
    -2-

    INSTRUCTION
    1. All details should be in Capital and Bold letters only application
    must be filled by the applicant only in neat legible hand.

    2. Three recent Passport size photographs should be enclosed to the


    Application Form. (don’t stapple the photos)*
    Do’s
    His / her clear & clarity, plain background, straight face, official
    passport size photo & within a week taken photographs only
    accepted.

    Dont’s
    His / her free hair, front hair, side face, selfie, scanned & old photo
    not accepted.

    3. *Fee : Rs.150/- payment by DD favouring Tamil Nadu Dental


    Council, payable at Chennai (Cash & Cheque not accepted).

    4. Xerox copy of Tamil Nadu Dental Council Registration Certificate.

    5. Xerox copy of Date of Birth proof (Transfer Certificate, Birth


    Certificate, Passport or issued by the competent authority).

    6. Xerox copy of Candidate Photo Identification proof in Tamil Nadu.


    (i.e. Aadhaar card, Voter id, Driving Licence & Passport)

    7. A self-addressed green cloth cover (6”x4” size) affixed with Rs.22/-


    Postal Stamps envelope enclosed herewith.

    8. Dentist’s should write his / her Name, Mobile Number, TN Dental


    Council registration number on the backside of the DD.

    9. Further Enquiry:- Please Contact our office


    Telephone No. 044 – 23638476

    *(Those who need both Id Card & Smart Board can


    take a single DD for Rs.950/-)

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