oo. RY me ks Ee ce eke cocauceh!

Father or Mother of the pupil

Name of the peer sa

rib. Hb 6

“+ Nftiondlty. eligion, snd Caste

*, ***** ****) aarcir Aeireueyid yoy) AMNeaysaher

senerwgnih grennt ret pmeen eenug)

Community whether he/she belongs to

rrcBt qos upmigy. ...

(a) 8 Sranidar (Se) oT

5) oan

us are

§ ard Glass. 7 Bsob Torsadu axgciy ia

Most Backward Class ad PrrGur QasPA@ 5) Aegis

ay, urRuodt aovs 3

Convert to Christianity (rom Scheduled Ca:

o) SCLamaii G55) B&siuLL Gerid...

si Denotified Communities ~

wrevailjurersdur nde SIL pig GMesile apres gsm ort pparme

MAGE Mayes oHr ab" crengy cupsGesin Dib. oe

I the pupil belongs to any one of the Five Categories mentioned above,

6. us ib ss a is

Sex

1. Spas C59 wremait Grima USGouyd

aster. erairenfigytb crap 46 gio ) on

Date of Birth as entered in the Admission

Register (in figures and words)

8. 21d 305s JmLWTos GMacir (a)

Persona! marks of Identification

Write "YES’ against then

2 (b)

9. usted Crréetuce C59 won Crisats

LELAIGHY, (MGL_Sops sTMSHTa op 5a)00)...

of admission and standard in which

(the year to be entered in words)

10. (29) wremart usiMeoudO Gigir srs He

wider mm 55 ui (craps Hed) su

Standard in which the pupil was studying at

the time of leaving (in words)

(3) $57595055 urLOGAa a 5rugy),

Qurgssial yds Asn iPosdl ... g s

The course offered i.e., General Education or

Vocational Education

(Q) Qurgt sdAwrider UGA Il Agreed ‘ie

(2) 57595045 Agius ur_maar

wppb Gorgon a ae a

In the case of General Education the subjecis

offered under Pari lll Group-A and Medium of

instruction QorPp sdsdurAcr uGA UI Asred

(48 Csr 595055 VariPpuriw

wane ugP Ill Garg) (21)2 O55 .

@srctyouw uri ate

In the cas? of Vocetional Educetion, the Voca-

tional subject under Part !I! Group-A and the

related ject offered under Part Ill Group-A

it a. ahi & orn innate

© eeceoaeen

(ver) DD Gur yf Medium of Study of ar

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