G0VERNMENT OF KERALA

DIRECTORATE OF GENERAL EDUCATION (HIGHER SECONDARY WING)

APPLICATION FOR ADMISSION TO THE HIGHER SECONDARY COURSE (2O21-2O22)
APPLICATION NO: 2103100879

Name: ANANDU ANIL KUMAR Guardian Name: ANIL KUMAR

Mother's Name: GEETHA ANILKUMAR Father's Name: ANIL KUMAR

Date of Birth: 17-12-2004 Sex: Male

Aadhaar No: 511XXXXXX836 Enrolement No: -

Board Passed: Yes Scheme: SSLC (2020-2021) Register Number: 274252

Month of Pass: 3 Year of Pass: 2021

Category Name: EzhavaThiyyaBillava (ETB) OEC: No

Caste: EZHAVA Religion: Hindu

Resident State: Kerala Resident Local Body: Koyipram

Resident District: Pathanamthitta Resident Taluk: Thiruvalla

Permanent Address: 476 LIG FLATS HASTSAL , UTTAMNAGAR Communication Address : KADUVATHRAYIL HOUSE PULLAD

NEWDELHI 110059 PATHANAMTHITTA 689548

1
Blind: No Deaf No OH: No

IEDC : - MR/Brain Diseases: No Health Club: No

Linguistic Minority:

Jawan Priority:

NTSE Qualified:
No

No

No
Minority Language:

NCC or Scout / Guide(Puraskars)

Science Club:

O
No

No 2 Jawan Killed In Action:

Scout / Guide Participation :

Social Science Club:

No

No

No

2
Forestry Club: No Environment/Nature Club: No IT Club: No

Maths Club: No Debating Club: No Philatery Club: No

Oratory Club:

Red Cross:
No

No
Lit Con(School Magazines):

Student Police Cadet:

- No

No
Lit Con (Periodicals):

Swim:
No

No

P
Little KITES Members With A Grade: No

SPORTS AND YOUTH FEST SL-I D-I / A D-II / B D-III / C DLP STATE FAIRS A-Grade B-Grade C-Grade D-Grade E-Grade

A
Sports Fest 0 0 0 0 0 State Science Fair 0 0 0 0 0

Youth Fest 0 0 0 0 0 State Social Science Fair 0 0 0 0 0

C
E-Mail ID: [email protected] State Maths Fair 0 0 0 0 0

Phone Number: 8527671710 State IT Fair 0 0 0 0 0

Chance Number:

SSLC School:

PAPER NAME
1

12345 Others

h s State Work Experience Fair 0 0 0 0

State Level First(SL-I), District First or A-Grade(D-I / A), District Second or B-Grade(D-II / B), District Third or C-Grade (D-III / C), District Level Participation(DLP)

CANDIDATE GRADE DETAILS

MARK GRADE GRADE POINT
0

First Language- I NA C 4

First Language- II NA B 6

English NA A 8

Hindi NA A 8

Social Science NA B 6

Physics NA B+ 7

Chemistry NA A+ 9

Biology NA A 8

Mathematics NA C+ 5

Information Technology NA A+ 9

IT Services : NIC Kerala Page 1 / 2 IP : 106.208.33.181 - Date & Time : 14/09/2021 12:07:20 PM
 CANDIDATE OPTION DETAILS (MAIN)

Pref School Code Course Pref School Code Course Pref School Code Course Pref School Code Course

No. Code No. Code No. Code No. Code

1 3022 5 2 3038 1 3 3028 5

.......................................................................................................................................................................................................
DECLARATION
I ANIL KUMAR, Parent of Master/Kumari ANANDU ANIL KUMAR do hereby declare that all the information furnished in the
application are true to the best of my belief. I know that the allotment got by any false information furnished in the application will
results in the cancellation of Allotment and Admission.

Name and Signature of Parent/Guardian

Place :
Date : 14-09-2021

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IT Services : NIC Kerala Page 2 / 2 IP : 106.208.33.181 - Date & Time : 14/09/2021 12:07:20 PM